Non-culprit artery myocardial infarction and complex coronary lesions in anterior ST-elevated myocardial infarction patients

Autor: Schaaf, Mathieu, Croisille, Pierre, Py, Agathe, Roubille, François, Biere, Loic, Bochaton, Thomas, Perret, Thibault, Belle, Loic, de Poli, Fabien, Hovasse, Thomas, Lairez, Olivier, Boussaha, Inesse, Rioufol, Gilles, Prunier, Fabrice, Ovize, Michel, Mewton, Nathan
Přispěvatelé: Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre d'Investigation Clinique [Bron] (CIC1407), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Saint-Etienne, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre hospitalier Saint Joseph - Saint Luc [Lyon], Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois], Centre hospitalier de Haguenau, Hôpital Privé Jacques Cartier [Massy], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), MORNET, Dominique
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Cardiology
Cardiology, Karger, In press, ⟨10.1159/000518137⟩
Cardiology, 2021, 146 (6), pp.728-736. ⟨10.1159/000518137⟩
ISSN: 0008-6312
1421-9751
DOI: 10.1159/000518137⟩
Popis: International audience; Aims: Periprocedural myocardial infarctions have been reported in the setting of planned percutaneous coronary intervention (PCI). We assessed the prevalence of nonculprit artery acute myocardial infarction (NCAMI) and its relationship with coronary artery characteristics, final infarct size, and 1-year adverse clinical outcomes in a population of anterior ST-elevated myocardial infarction (STEMI) patients.Methods and results: Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) studies were performed within 7 days of admission in 129 anterior STEMI patients from the CIRCUS trial treated by primary PCI. Infarct in the noninfarct artery territory (circumflex, right coronary) was assessed on LGE-CMR and T2-weighted images. Eleven (8.5%) patients exhibited NCAMI. The only independent characteristic significantly associated with NCAMI was the presence of multiple complex coronary lesions (odds ratio = 12.9, 95% confidence interval [3.1-53.4]; p < 0.001). There was a significantly increased infarct size in NCAMI patients compared to patients without NCAMI (45.8 ± 20.4% of the left ventricle [LV] vs. 31.0 ± 15.1% of LV, respectively; p = 0.02), with lower LV ejection fraction (46 ± 10% vs. 34 ± 8%, respectively; p < 0.001).Conclusion: NCAMIs are present in 8.5% of anterior STEMI patients and are significantly associated with multiple complex coronary lesions without significant relationship to any revascularization procedural technique. NCAMI was associated with a greater infarct size and reduced LVEF but not worse clinical outcomes at 1 year.
Databáze: OpenAIRE
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