Acute myocardial infarction due to left main coronary artery disease: a large multicenter national registry
| Autor: | Lech Poloński, Agnieszka Janion-Sadowska, Wojciech Gutkowski, Marek Gierlotka, Marcin Sadowski, Marianna Janion, Mariusz Gąsior |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome Time Factors medicine.medical_treatment Population Myocardial Infarction Coronary Artery Disease Kaplan-Meier Estimate Sex Factors Risk Factors Internal medicine Angioplasty medicine Humans Myocardial infarction Hospital Mortality Registries Angioplasty Balloon Coronary education Aged Retrospective Studies education.field_of_study business.industry Cardiogenic shock Age Factors Coronary Stenosis Percutaneous coronary intervention General Medicine Middle Aged medicine.disease Treatment Outcome Conventional PCI Cardiology Female Myocardial infarction diagnosis Poland Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology journal. 20(2) |
| ISSN: | 1898-018X |
| Popis: | Background: Optimal management of patients with acute myocardial infarction (MI) due to critical stenosis of an unprotected left main coronary artery (ULMCA) is not established. However, data from observational studies and registries encourage to perform percutaneous coronary intervention (PCI) in high risk patients. We investigated gender-related discrepancies, clinical course and prognosis in patients with acute MI and ULMCA as an infarct-related artery. Methods: A total of 643 consecutive patients (184 [28.6%] females and 459 [71.4%] males) with acute MI due to critical ULMCA stenosis were selected from the population of 121,526 patients hospitalized due to acute coronary syndromes between 2003 and 2006. The primary endpoints were in-hospital, 30-day, 6-month and 12-month mortality. Results: Women were older than men with signifi cantly higher proportion of women older than 65 and with unfavorable risk profi le. The management in men and women was similar. There was no signifi cant gender-related differences in mortality in all follow-up periods. In multivariate analysis cardiogenic shock, pulmonary edema, ST elevation myocardial infarction (STEMI) and advanced age signifi cantly increased mortality, whereas successful PCI decreased mortality. Conclusions: No signifi cant differences in clinical course, treatment and prognosis between men and women were noted. Mortality remained very high in both genders. The most unfavorable prognostic factors were cardiogenic shock, pulmonary edema, STEMI and advanced age. Percutaneous coronary angioplasty is feasible and offers high success rate in this subset of patients. (Cardiol J 2013; 20, 2: 190–196) |
| Databáze: | OpenAIRE |
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