Right ventricular branch compromise after percutaneous coronary intervention and baseline chronic kidney disease: A high-risk combination associated with long-term prognoses in acute inferior myocardial infarction
| Autor: | Yutaka Otsuji, Masaru Araki, Yutaro Naka, Masaaki Takeuchi, Konosuke Inoue, Toshiya Miura, Shinjo Sonoda, Yoshihisa Fujino, Hiroki Okabe, Masaharu Kataoka, Koshi Setoyama, Reo Anai |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Inferior Wall Myocardial Infarction Coronary Angiography Percutaneous Coronary Intervention Risk Factors Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Risk factor Renal Insufficiency Chronic Retrospective Studies business.industry Cardiogenic shock Hazard ratio Percutaneous coronary intervention medicine.disease Prognosis Coronary Vessels Treatment Outcome Heart failure Conventional PCI Cardiology Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | Journal of cardiology. 78(5) |
| ISSN: | 1876-4738 |
| Popis: | Background: Right ventricular branch compromise (RVBC) following percutaneous coronary intervention (PCI) in patients with acute inferior myocardial infarction (AIMI) is associated with short-term adverse clinical outcomes. Chronic kidney disease (CKD) is also known to be a major risk factor after PCI in AIMI. However, little is known about the impact of RVBC and CKD on long-term prognosis. Methods: From January 2009 to January 2019, we retrospectively enrolled 90 consecutive patients with ST-elevation AIMI who had a culprit lesion in the proximal-to-mid right coronary arteries and underwent PCI in our institution. After the measurement of the Thrombolysis in Myocardial Infarction frame counts in RV branches using post-PCI angiography, we divided them into two groups (RVBC, n = 49; non-RVBC, n = 41), and investigated their long-term prognosis for 43±31 months. The primary endpoint was the incidence of major adverse cardiac events (MACEs), including all-cause death, nonfatal MI, congestive heart failure requiring hospitalization, and life-threatening arrhythmia. Results: Both groups showed similar clinical characteristics; however, the baseline right ventricular function after PCI was significantly worse in RVBC than in non- RVBC. Twenty-four MACEs occurred during the follow-up (RVBC vs. non-RVBC: 37% vs. 14%, p = 0.002). In the multivariate analysis, both RVBC and baseline CKD were powerful predictors of MACEs (RVBC: hazard ratio [HR] 2.85, CKD: HR 2.29). Baseline CKD showed higher hazard ratios of MACEs in RVBC (CKD: HR 7.19 vs. non-CKD: HR 0.24). Conclusions: The prognoses of RVBC after primary PCI in patients with AIMI were poor. Baseline CKD and RVBC were associated with poor long-term clinical outcomes. |
| Databáze: | OpenAIRE |
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