Impact of Chronic Total Occlusions on Markers of Reperfusion, Infarct Size, and Long-Term Mortality

Autor: Iwan C. C. van der Horst, Marthe A. Kampinga, Chris P. H. Lexis, Youlan L. Gu, Bart J.G.L. de Smet, Braim M. Rahel, Monique A. S. Lexis, Felix Zijlstra
Přispěvatelé: Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), Promovendi PHPC, Epidemiologie, RS: CAPHRI School for Public Health and Primary Care
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Male
myocardial blush grade
medicine.medical_treatment
Myocardial Infarction
Coronary Angiography
Electrocardiography
Risk Factors
Odds Ratio
Creatine Kinase
MB Form
Medicine
Myocardial infarction
Angioplasty
Balloon
Coronary
THROMBUS ASPIRATION
Netherlands
Thrombectomy
ST-segment elevation resolution
Myocardial Perfusion Imaging
General Medicine
Middle Aged
reperfusion
Treatment Outcome
medicine.anatomical_structure
ST-elevation myocardial infarction
Cardiology
SURVIVAL
Female
Cardiology and Cardiovascular Medicine
Artery
medicine.medical_specialty
ACUTE MYOCARDIAL-INFARCTION
PHASE
PERCUTANEOUS CORONARY INTERVENTION
Collateral Circulation
Suction
Risk Assessment
12-LEAD ELECTROCARDIOGRAM
Coronary Circulation
Internal medicine
Angioplasty
Humans
Radiology
Nuclear Medicine and imaging
Risk factor
ANGIOPLASTY
Aged
Proportional Hazards Models
Chi-Square Distribution
business.industry
pathologic Q waves
Myocardium
Percutaneous coronary intervention
Odds ratio
Infarct size
medicine.disease
Confidence interval
Logistic Models
Coronary Occlusion
Chronic Disease
business
Biomarkers
SYSTEM
Zdroj: Catheterization and Cardiovascular Interventions, 77(4), 484-491. Wiley
Catheterization and Cardiovascular interventions, 77(4), 484-491. Wiley
ISSN: 1522-1946
Popis: Objectives: This study evaluated the impact of a chronic total occlusion (CTO) in a non-infarct related coronary artery (IRA) on markers of reperfusion, infarct size, and long-term cardiac mortality in patients with ST-elevation myocardial infarction (STEM!). Background: A concurrent CTO in STEMI patients has been associated with impaired left ventricular function and outcome. However, the impact on markers of reperfusion is unknown. Methods: All 1,071 STEMI patients included in the TAPAS-trial between January 2005 and December 2006 were used for this substudy. Endpoints were the association between a CTO in a non-IRA and myocardial blush grade (MBG) of the IRA, ST-segment elevation resolution (STR), enzymatic infarct size, and clinical outcome. Results: A total of 90 patients (8.4%) had a CTO. MBG 0 or 1 occurred more often in the CTO group (34.2% versus 20.6% (Odds Ratio [OR] 2.00, 95% confidence interval [CI]: 1.22-3.23, P = 0.006)). Incomplete STR occurred more often in the CTO group, (63.6% versus 48.2% [OR 1.96, 95% CI: 1.22-3.13, P = 0.005]). Median level of maximal myocardial-band of creatinin kinase (CK-MB) in the CTO group was 75 mu g/l (IQR 28-136) and 51 mu g/l (IQR 18-97) in the no-CTO group (P = 0.021). The presence of a CTO in a non-IRA in STEMI patients was an independent risk factor for cardiac mortality (HR 2.41, 95% CI: 1.26-4.61, P = 0.008) at 25 months follow-up. Conclusion: A CTO in a non-IRA is associated with impaired reperfusion markers and impaired long-term outcome in STEMI patients. (C) 2010 Wiley-Liss, Inc.
Databáze: OpenAIRE
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