New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion
Objectives. The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main cor...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2019/8238972 |
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| author | Cãlin Homorodean Adrian Corneliu Iancu Daniel Leucuţa Şerban Bãlãnescu Ioana Mihaela Dregoesc Mihai Spînu Mihai Ober Dan Tãtaru Maria Olinic Dan Bindea Dan Olinic |
| author_facet | Cãlin Homorodean Adrian Corneliu Iancu Daniel Leucuţa Şerban Bãlãnescu Ioana Mihaela Dregoesc Mihai Spînu Mihai Ober Dan Tãtaru Maria Olinic Dan Bindea Dan Olinic |
| author_sort | Cãlin Homorodean |
| collection | DOAJ |
| description | Objectives. The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery lesion (UPLMCA). Background. Previous studies on primary PCI in UPLMCA have identified cardiogenic shock, TIMI 0/1 flow, and cardiac arrest, as prognostic factors of an unfavourable outcome, but the complexity of coronary artery disease and the extent of revascularization have not been thoroughly investigated in these high-risk patients. Methods. 30-day, 1-year, and long-term outcomes were analyzed in a cohort of retrospectively selected, 81 consecutive patients with STEMI, and primary PCI on UPLMCA. Results. Cardiogenic shock (p=0.001), age (p=0.008), baseline SYNTAX Score II (p=0.006), and SYNTAX Revascularization Index (p=0.046) were independent mortality predictors at one-year follow-up. Besides cardiogenic shock (HR 3.28, p<0.001), TIMI 0/1 flow (HR 2.17, p=0.021) and age (HR 1.03, p=0.006), baseline SYNTAX Score II (HR 1.06, p=0.006), residual SYNTAX Score (HR 1.03, p=0.041), and SYNTAX Revascularization Index (HR 0.9, p=0.011) were independent predictors of mortality at three years of follow-up. In patients with TIMI 0/1 flow, the presence of Rentrop collaterals was an independent predictor for long-term survival (HR 0.24; p=0.049). Conclusions. In this study, the complexity of coronary artery disease and the extent of revascularization represent independent mortality predictors at long-term follow-up. |
| format | Article |
| id | doaj-art-b3f3a852866c474fae7773bed136e630 |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-b3f3a852866c474fae7773bed136e6302025-02-03T06:14:17ZengWileyJournal of Interventional Cardiology0896-43271540-81832019-01-01201910.1155/2019/82389728238972New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit LesionCãlin Homorodean0Adrian Corneliu Iancu1Daniel Leucuţa2Şerban Bãlãnescu3Ioana Mihaela Dregoesc4Mihai Spînu5Mihai Ober6Dan Tãtaru7Maria Olinic8Dan Bindea9Dan Olinic10“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaEmergency County Hospital, Cluj-Napoca, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania“Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaObjectives. The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery lesion (UPLMCA). Background. Previous studies on primary PCI in UPLMCA have identified cardiogenic shock, TIMI 0/1 flow, and cardiac arrest, as prognostic factors of an unfavourable outcome, but the complexity of coronary artery disease and the extent of revascularization have not been thoroughly investigated in these high-risk patients. Methods. 30-day, 1-year, and long-term outcomes were analyzed in a cohort of retrospectively selected, 81 consecutive patients with STEMI, and primary PCI on UPLMCA. Results. Cardiogenic shock (p=0.001), age (p=0.008), baseline SYNTAX Score II (p=0.006), and SYNTAX Revascularization Index (p=0.046) were independent mortality predictors at one-year follow-up. Besides cardiogenic shock (HR 3.28, p<0.001), TIMI 0/1 flow (HR 2.17, p=0.021) and age (HR 1.03, p=0.006), baseline SYNTAX Score II (HR 1.06, p=0.006), residual SYNTAX Score (HR 1.03, p=0.041), and SYNTAX Revascularization Index (HR 0.9, p=0.011) were independent predictors of mortality at three years of follow-up. In patients with TIMI 0/1 flow, the presence of Rentrop collaterals was an independent predictor for long-term survival (HR 0.24; p=0.049). Conclusions. In this study, the complexity of coronary artery disease and the extent of revascularization represent independent mortality predictors at long-term follow-up.http://dx.doi.org/10.1155/2019/8238972 |
| spellingShingle | Cãlin Homorodean Adrian Corneliu Iancu Daniel Leucuţa Şerban Bãlãnescu Ioana Mihaela Dregoesc Mihai Spînu Mihai Ober Dan Tãtaru Maria Olinic Dan Bindea Dan Olinic New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion Journal of Interventional Cardiology |
| title | New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion |
| title_full | New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion |
| title_fullStr | New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion |
| title_full_unstemmed | New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion |
| title_short | New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion |
| title_sort | new predictors of early and late outcomes after primary percutaneous coronary intervention in patients with st segment elevation myocardial infarction and unprotected left main coronary artery culprit lesion |
| url | http://dx.doi.org/10.1155/2019/8238972 |
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