Long-term survival after surgical treatment for post-infarction mechanical complications: results from the Caution study.

Autor:	Matteucci M; Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.; Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy.; Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland., Ronco D; Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.; Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland.; Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan, Italy., Kowalewski M; Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland.; Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior, Warsaw, Poland., Massimi G; Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.; Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland., De Bonis M; Cardiothoracic Surgery Department, San Raffaele University Hospital, Milan, Italy., Formica F; Department of Medicine and Surgery, University of Parma, Cardiac Surgery Unit, University Hospital of Parma, Parma, Italy., Jiritano F; Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.; Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland.; Department of Experimental and Clinical Medicine, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy., Folliguet T; Department of Cardio-Thoracic Surgery, University Hospital Henri-Mondor, Créteil, Paris, France., Bonaros N; Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria., Sponga S; Cardiothoracic Department, University Hospital of Udine, Udine, Italy., Suwalski P; Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior, Warsaw, Poland., De Martino A; Section of Cardiac Surgery, University Hospital, Pisa, Italy., Fischlein T; Department of Cardiac Surgery, Cardiovascular Center, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany., Troise G; Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Brescia, Italy., Dato GA; Cardiac Surgery Department, Mauriziano Hospital, Turin, Italy., Serraino FG; Department of Experimental and Clinical Medicine, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy., Shah SH; Cardiovascular and Thoracic Surgery Department, King Fahad Medical City, Riyadh, Saudi Arabia., Scrofani R; Cardiac Surgery Unit, Fondazione Ospedale Maggiore Policlinico IRCCS Cà Granda, University of Milan, Milan, Italy., Kalisnik JM; Department of Cardiac Surgery, Cardiovascular Center, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany., Colli A; Section of Cardiac Surgery, University Hospital, Pisa, Italy., Russo CF; Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Hospital, Milan, Italy., Ranucci M; Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Italy., Pettinari M; Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium., Kowalowka A; Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland., Thielmann M; Department of Thoracic and Cardiovascular Surgery, West-German Heart Center, University of Duisburg-Essen, Essen, Germany., Meyns B; Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium., Khouqeer F; Department of Cardiac Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia., Obadia JF; Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Lyon, France., Boeken U; Department of Cardiovascular Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany., Simon C; Cardiovascular and Transplant Department, Papa Giovanni XXIII Hospital, Bergamo, Italy., Naito S; Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany., Musazzi A; Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy., Lorusso R; Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.; Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
Jazyk:	angličtina
Zdroj:	European heart journal. Quality of care & clinical outcomes [Eur Heart J Qual Care Clin Outcomes] 2024 Dec 19; Vol. 10 (8), pp. 737-749.
DOI:	10.1093/ehjqcco/qcae010
Abstrakt:	Aims: Mechanical complications (MCs) are rare but potentially fatal sequelae of acute myocardial infarction (AMI). Surgery, though challenging, is considered the treatment of choice. The authors sought to study the early and long-term results of patients undergoing surgical treatment for post-AMI MCs. Methods and Results: Patients who underwent surgical treatment for post-infarction MCs between 2001 through 2019 in 27 centres worldwide were retrieved from the database of the CAUTION study. In-hospital and long-term mortality were the primary outcomes. Cox proportional hazards regression models were used to determine independent factors associated with overall mortality. The study included 720 patients. The median age was 70.0 [62.0-77.0] years, with a male predominance (64.6%). The most common MC encountered was ventricular septal rupture (VSR) (59.4%). Cardiogenic shock was seen on presentation in 56.1% of patients. In-hospital mortality rate was 37.4%; in more than 50% of cases, the cause of death was low cardiac output syndrome (LCOS). Late mortality occurred in 133 patients, with a median follow-up of 4.4 [1.0-8.6] years. Overall survival at 1, 5, and 10 years was 54.0, 48.1, and 41.0%, respectively. Older age (P < 0.001) and post-operative LCOS (P < 0.001) were independent predictors of overall mortality. For hospital survivors, 10-year survival was 65.7% and was significantly higher for patients with VSR than those with papillary muscle rupture (long-rank P = 0.022). Conclusion: Contemporary data from a multicentre cohort study show that surgical treatment for post-AMI MCs continues to be associated with high in-hospital mortality rates. However, long-term survival in patients surviving the immediate post-operative period is encouraging. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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