Post-PCI outcomes in STEMI patients with coronary ectasia: meta-analysis.

Autor:	Mir T; Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, USA., Sattar Y; Department of Internal medicine, Icahn School of Medicine at Mount Sinai, New York, USA., Uddin M; Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, USA., Changal KH; Department of Cardiovascular Medicine, University of Toledo Health Sciences, Toledo, USA., Kumar K; Department of Cardiovascular Medicine, Detroit Medical Center, Wayne State University, Detroit, USA., Attique HB; Department of Internal Medicine, University of Connecticut, Farmington, USA., Kabashneh S; Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, USA., Ullah W; Department of Internal Medicine, Abington Jefferson Health, Abington, PA, USA., Lohia P; Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, USA., Alraies MC; Department of Cardiovascular Medicine, Detroit Medical Center, Wayne State University, Detroit, USA., Blank N; Department of Cardiovascular Medicine, Detroit Medical Center, Wayne State University, Detroit, USA., Afonso L; Department of Cardiovascular Medicine, Detroit Medical Center, Wayne State University, Detroit, USA., Qureshi WT; Department of Cardiology,University of Massachusetts School of Medicine, Worcester, MA, USA.
Jazyk:	angličtina
Zdroj:	Expert review of cardiovascular therapy [Expert Rev Cardiovasc Ther] 2021 Apr; Vol. 19 (4), pp. 349-356. Date of Electronic Publication: 2021 Apr 14.
DOI:	10.1080/14779072.2021.1889370
Abstrakt:	Background: Coronary ectasia (CE) is defined as dilation of the coronary artery, 1.5 times that of the surrounding vessel. Outcomes of percutaneous intervention (PCI) in patients with CE presenting as ST-elevated myocardial infarction (STEMI) remain a topic of debate. Methods: Studies comparing outcomes of PCI in CE versus no-ectasia (NE) STEMI patients were identified. Baseline angiographic characteristics include thrombolysis in myocardial infarction (TIMI) 0-1 flow, right coronary artery (RCA) involvement, and primary outcomes including thrombus aspiration, no-reflow, mortality, and TIMI-3 post-PCI. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Results: Six studies (n = 5746, CE-340 and NE-5406) qualified for the analysis. RCA involvement was more common in CE than NE, OR-1.39 (95%CI1.06-1.82, p-0.02). Pre-procedure TIMI-0-1 was of comparable results between the groups (p-1.13). Higher thrombus aspiration for CE (OR 2.18, 95%CI1.44-3.32;p-<0.001). CE had higher incidence of no-reflow (OR 4.07, 95%CI2.42-6.84;p-<0.001). TIMI-3 flow post-PCI was achieved less commonly in the CE group (OR-0.64, 95%CI-0.48-0.86;p-<0.001). Mortality on follow-up was comparable (0.83, 95%CI0.39-1.78;p-0.63). Metaregression analysis did not show confounding effects from comorbidities. Conclusion: Coronary ectasia patients with STEMI had higher rates of PCI failure and no-reflow than NE; however, mortality during follow-up was comparable.
Databáze:	MEDLINE
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