التفاصيل البيبلوغرافية
| العنوان: |
Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery Disease as Culprit Lesion in Patients With Acute Myocardial Infarction |
| المؤلفون: |
Vito Ramazzotti, Mamas A. Mamas, Francesco Prati, Fabrizio Imola, Alessandro Pappalardo, Alessandro Manzoli, Magdi El-Omar |
| المصدر: |
JACC: Cardiovascular Interventions. 4(6):618-626 |
| بيانات النشر: |
Elsevier BV, 2011. |
| سنة النشر: |
2011 |
| مصطلحات موضوعية: |
Male, left main coronary artery, Emergency Medical Services, medicine.medical_specialty, Ticlopidine, medicine.medical_treatment, Bundle-Branch Block, Myocardial Infarction, Shock, Cardiogenic, acute myocardial infarction, Coronary Artery Disease, Internal medicine, Confidence Intervals, Odds Ratio, Health Status Indicators, Humans, Medicine, Hospital Mortality, Myocardial infarction, Survival rate, Aged, Retrospective Studies, business.industry, Cardiogenic shock, Angioplasty, percutaneous coronary intervention, Hemodynamics, Electrocardiography in myocardial infarction, Percutaneous coronary intervention, Prognosis, medicine.disease, Coronary Vessels, Thrombosis, Clopidogrel, Logistic Models, Treatment Outcome, Italy, Conventional PCI, Cardiology, Female, business, Cardiology and Cardiovascular Medicine, Platelet Aggregation Inhibitors, TIMI |
| الوصف: |
Objectives This study sought to evaluate short- and long-term outcomes of patients undergoing emergency percutaneous coronary intervention (PCI) for acute myocardial infarction due to a culprit lesion in an unprotected left main coronary artery. Methods In this retrospective, 2-center, international observational study, 5,261 patients were admitted between February 2005 and December 2008 with acute myocardial infarction and treated with PCI; of these, 1,277 were ST-segment elevation myocardial infarction and 3,984 non–ST-segment elevation myocardial infarction. We identified 48 patients among this cohort who underwent emergency PCI to an unprotected left main coronary artery culprit lesion. Results Mean age was 70 ± 12.5 years, and 45% of the patients presented with ST-segment elevation myocardial infarction or new left bundle branch block. Cardiogenic shock was present in 45%, and distal left main coronary artery disease was present in 71% of patients. Angiographic procedural success was achieved in 92% of patients. Overall in-hospital mortality was 21%, due in all cases to refractory, multiorgan failure. Twenty-five percent experienced major adverse cardiac events, defined as death, myocardial infarction, stent thrombosis, and target vessel revascularization. In patients presenting in cardiogenic shock, in-hospital mortality was 32%. At 1-year follow-up, in-hospital survivors had a mortality rate of 10.5%, whereas 18.4% experienced subsequent major adverse cardiac events. Long-term prognosis was excellent in hospital survivors with a 1-year survival rate of 89.5%. Conclusions Patients with acute myocardial infarction and thrombosis of the unprotected left main coronary artery are a high-risk subgroup with a substantial mortality, particularly if they present in cardiogenic shock. We demonstrate that in these patients, PCI is a feasible treatment option associated with reasonably good outcomes. Long-term prognosis is excellent in hospital survivors with an 89.5% survival rate at 1 year. |
| تدمد: |
1936-8798 |
| DOI: |
10.1016/j.jcin.2011.02.016 |
| URL الوصول: |
https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2e94372524e8bebe16c5d4b0b94087a4 |
| Rights: |
OPEN |
| رقم الانضمام: |
edsair.doi.dedup.....2e94372524e8bebe16c5d4b0b94087a4 |
| قاعدة البيانات: |
OpenAIRE |