Evaluation of the Effect of a Concurrent Chronic Total Occlusion on Long-Term Mortality and Left Ventricular Function in Patients After Primary Percutaneous Coronary Intervention

Autor: René J. van der Schaaf, Marije M. Vis, Annemarie E. Engström, Nienke K. Stegenga, Jan G.P. Tijssen, Robbert J. de Winter, Jose Ps. Henriques, Bimmer E. Claessen, Wouter J. Kikkert, Niels J.W. Verouden, Jan Baan, Krischan D. Sjauw, Karel T. Koch, Jan J. Piek
Přispěvatelé: Cardiology, ACS - Amsterdam Cardiovascular Sciences, General Internal Medicine
Rok vydání: 2009
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Myocardial Infarction
Kaplan-Meier Estimate
Risk Assessment
Severity of Illness Index
Ventricular Function
Left
Cohort Studies
left ventricular function
Risk Factors
Internal medicine
Angioplasty
Odds Ratio
medicine
Humans
cardiovascular diseases
Myocardial infarction
Angioplasty
Balloon
Coronary
chronic total occlusion
Proportional Hazards Models
Ejection fraction
Proportional hazards model
business.industry
Hazard ratio
Coronary Stenosis
Percutaneous coronary intervention
Stroke Volume
Odds ratio
Middle Aged
medicine.disease
mortality
Surgery
Logistic Models
Treatment Outcome
Coronary Occlusion
Chronic Disease
Conventional PCI
cardiovascular system
Cardiology
Female
prognosis
Cardiology and Cardiovascular Medicine
business
Zdroj: JACC. Cardiovascular interventions, 2(11), 1128-1134. Elsevier Inc.
ISSN: 1936-8798
1876-7605
DOI: 10.1016/j.jcin.2009.08.024
Popis: Objectives The aim of this study was to evaluate the effect of a concurrent chronic total occlusion (CTO) in patients with ST-segment elevation myocardial infarction (STEMI) on long-term mortality and left ventricular ejection fraction (LVEF). Background The impact of a CTO in a non-infarct-related artery (IRA) on prognosis after STEMI is unknown. Methods Between 1997 and 2005, we admitted 3,277 STEMI patients treated with primary percutaneous coronary intervention. Patients were categorized as single-vessel disease (SVD), multivessel disease (MVD) without CTO, and MVD with a CTO in a non-IRA. We performed a "landmark survival analysis" to 5 years follow-up with a landmark set at 30 days. Additionally, we analyzed the evolution of LVEF within 1 year. Results Of the patients, 2,115 (65%) had SVD, 742 patients (23%) had MVD without CTO, and 420 patients (13%) had a concurrent CTO. Presence of a CTO was a strong and independent predictor for 30-day mortality (hazard ratio [HR]: 3.6, 95% confidence interval [CI]: 2.6 to 4.7, p
Databáze: OpenAIRE
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