Immediate complete revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease treated by primary percutaneous coronary intervention Insights from the ORBI registry

Autor: Djamel Saouli, Isabelle Coudert, B. Boulanger, Martine Gilard, Vincent Auffret, Anna Pimor, Marc Bedossa, Régis Delaunay, Dominique Boulmier, Emmanuelle Filippi, Marielle Le Guellec, Guillaume Leurent, Emilie Bot, Gilles Rouault, Jean-Philippe Hacot, Hervé Le Breton, Romain Didier, Philippe Druelles
Přispěvatelé: Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), CHU de Saint-Brieuc, Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de cardiologie et maladies vasculaires, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Optimisation des régulations physiologiques ( ORPHY (EA 4324) ), Université de Brest ( UBO ) -Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Université de Brest ( UBO ), CHU Saint Brieuc, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Évènements cardiovasculaires majeurs
Time Factors
medicine.medical_treatment
Coronary Artery Disease
030204 cardiovascular system & hematology
0302 clinical medicine
Recurrence
Risk Factors
Clinical endpoint
Hospital Mortality
Registries
030212 general & internal medicine
Myocardial infarction
[ SDV.IB ] Life Sciences [q-bio]/Bioengineering
Stroke
Multivessel disease
Hazard ratio
General Medicine
Middle Aged
3. Good health
Atteinte coronaire pluritronculaire
Treatment Outcome
Cardiology
Female
[SDV.IB]Life Sciences [q-bio]/Bioengineering
France
Cardiology and Cardiovascular Medicine
Complete revascularization
SCA ST+
medicine.medical_specialty
Hemorrhage
MACE
Mortalité
Revascularization
Time-to-Treatment
STEMI
03 medical and health sciences
Percutaneous Coronary Intervention
Internal medicine
medicine
Humans
cardiovascular diseases
Mortality
Aged
Retrospective Studies
business.industry
Coronary Thrombosis
Percutaneous coronary intervention
medicine.disease
Heart failure
Revascularisation complète
ST Elevation Myocardial Infarction
business
Mace
Zdroj: Archives of cardiovascular diseases
Archives of cardiovascular diseases, 2018, 111 (11), pp.656-665. ⟨10.1016/j.acvd.2017.08.005⟩
Archives of Cardiovascular Diseases
Archives of Cardiovascular Diseases, 2017, 〈10.1016/j.acvd.2017.08.005〉
Archives of cardiovascular diseases, Elsevier/French Society of Cardiology, 2018, 111 (11), pp.656-665. ⟨10.1016/j.acvd.2017.08.005⟩
ISSN: 1875-2136
1875-2128
Popis: International audience; Background - Recent studies demonstrated the superiority of complete revascularization (CR) in patients treated by primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI). Aim - To evaluate whether immediate CR improves in-hospital outcomes in patients with STEMI with multivessel disease. Methods - Data from a prospective multicentre registry including 9365 patients with STEMI were analysed. Patients with multivessel disease and treated with pPCI (n=3412) were included and separated into two groups according to whether immediate CR was performed during the index procedure. The primary endpoint was in-hospital major adverse cardiovascular events (MACE), defined as a composite of all-cause death, non-fatal myocardial infarction, stroke and definite stent thrombosis. Secondary endpoints were individual components of MACE and major bleeding. Multivariable Cox regression and propensity-score adjustment were performed to account for confounders. Results - Immediate CR was performed in 98 patients (2.9%), whereas 3314 patients (97.1%) were incompletely revascularized. The prevalence of severe heart failure (Killip class III or IV) and significant lesions of the left main coronary artery were higher in the immediate CR group (21.6% vs. 13.5% and 24.5% vs. 6.7%, respectively; P
Databáze: OpenAIRE
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