The prognostic impact of revascularization strategy in acute myocardial infarction and cardiogenic shock: Insights from the British Columbia Cardiac Registry
| Autor: | M. Bilal Iqbal, Tej Sheth, Andrew H. McNeice, David A. Wood, Imad J. Nadra, Eve Aymong, Simon D. Robinson, Anthony Della Siega, Lillian Ding, Albert W. Chan, Eric Fretz, Sanjit S. Jolly, Anthony Fung, John G. Webb, Steven Hodge, Shamir R. Mehta |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Shock Cardiogenic Disease 030204 cardiovascular system & hematology Revascularization Risk Assessment Culprit 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Risk Factors Internal medicine medicine Humans Radiology Nuclear Medicine and imaging In patient Registries cardiovascular diseases 030212 general & internal medicine Myocardial infarction Non-ST Elevated Myocardial Infarction Aged Retrospective Studies Aged 80 and over British Columbia business.industry Cardiogenic shock Percutaneous coronary intervention General Medicine medicine.disease Treatment Outcome Conventional PCI Cardiology ST Elevation Myocardial Infarction Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Catheterization and Cardiovascular Interventions. 92:E356-E367 |
| ISSN: | 1522-1946 |
| Popis: | BACKGROUND In patients with acute myocardial infarction (AMI) and cardiogenic shock (CS), percutaneous coronary intervention (PCI) of the culprit vessel is associated with improved outcomes. A large majority of these patients have multivessel disease (MVD). Whether or not PCI of non-culprit disease in the acute setting improves outcomes continues to be debated. We evaluated the prognostic impact of revascularization strategy for patients presenting with AMI and CS. METHODS We compared culprit vessel intervention (CVI) versus multivessel intervention in 649 patients with AMI, CS, and MVD enrolled in the British Columbia Cardiac Registry. We evaluated mortality at 30 days and 1 year. RESULTS CVI was associated with lower mortality at 30 days (23.7% vs. 34.5%, P = 0.004) and 1 year (32.6% vs. 44.3%, P = 0.003). CVI was an independent predictor for survival at 30 days (HR = 0.63, 95% CI: 0.45-0.88, P = 0.009) and 1 year (HR = 0.72, 95% CI: 0.54-0.96, P = 0.027). These findings were confirmed in propensity-matched cohorts. Subgroup analyses indicated that CVI was associated with lower mortality in patients aged |
| Databáze: | OpenAIRE |
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