Impact of Elective, Uncomplicated Target Lesion Revascularization on Cardiac Mortality After Elective Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery Disease

Autor: Francesco Saia, Mihail Celeski, Mateusz Orzalkiewicz, Antonio Bruno, Nazzareno Galiè, Nevio Taglieri, Cinzia Marrozzini, Miriam Compagnone, Elena Nardi, Tullio Palmerini, Gabriele Ghetti, Maria Letizia Bacchi Reggiani
Přispěvatelé: Compagnone M., Taglieri N., Celeski M., Ghetti G., Marrozzini C., Reggiani M.-L.B., Nardi E., Orzalkiewicz M., Bruno A.G., Galie N., Saia F., Palmerini T.
Rok vydání: 2020
Předmět:
Male
Reoperation
medicine.medical_specialty
Heart Diseases
Prognosi
medicine.medical_treatment
Myocardial Infarction
Coronary Artery Disease
030204 cardiovascular system & hematology
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Internal medicine
Myocardial Revascularization
medicine
Clinical endpoint
Humans
030212 general & internal medicine
Myocardial infarction
Stroke
Aged
Proportional Hazards Models
Aged
80 and over
Elective Surgical Procedure
business.industry
Cardiogenic shock
Hazard ratio
Percutaneous coronary intervention
Middle Aged
Prognosis
medicine.disease
Heart Disease
medicine.anatomical_structure
Italy
Elective Surgical Procedures
Conventional PCI
Proportional Hazards Model
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Human
Artery
Zdroj: The American Journal of Cardiology. 128:94-100
ISSN: 0002-9149
Popis: This study sought to investigate the impact of elective, uncomplicated target lesion revascularization (TLR) on long-term cardiac mortality after percutaneous coronary intervention (PCI) of unprotected left main coronary artery (ULMCA) disease. Consecutive patients undergoing PCI for ULMCA disease between January 2003 and December 2015 in 1 interventional center in Northern Italy were included. Patients presenting with cardiogenic shock, ST-segment elevation myocardial infarction (MI), as well as those undergoing urgent or complicated TLR were excluded. The primary endpoint of the study was cardiac mortality. Among the 418 patients fulfilling the study criteria, 79 (18.46%) underwent elective, uncomplicated TLR. After a median follow-up of 5.5 years, there were 23 cardiac deaths among patients undergoing elective, uncomplicated TLR versus 50 in patients not undergoing TLR. After adjusting for possible confounders, TLR was an independent predictor of cardiac mortality (Hazard ratio [HZ] = 1.92, 95% confidence interval [CI]: 1.05 to 3.49; p = 0.03). Patients undergoing TLR had also significantly higher rates of the composite of cardiac death, MI and stroke compared with the no TLR group (adjusted HR = 1.76, 95% CI 1.14 to 2.72). In conclusion, elective, uncomplicated TLR after PCI of ULMCA disease is associated with increased risk of long-term cardiac mortality. Reducing the risk of TLR after PCI of ULMCA disease may potentially improve the survival of these patients.
Databáze: OpenAIRE
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