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Multivessel disease and risk of infarct related artery restenosis in patients with acute coronary syndromes treated with PCI. Prospective study.
MedLine Citation:
PMID:  25179483     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Interventional treatment of patients with acute coronary syndromes (ACS) improves prognosis. However, despite the development of percutaneous coronary intervention (PCI), the risk of cardiovascular events in patients with multivessel coronary artery disease (MVD) remains significant. The aim of this study was to evaluate the risk of complications and the prognostic value of MVD in patients with ACS in one-year follow-up.
METHODS: A group of 153 patients with ACS was observed at a single cardiological center with 24hrs hemodynamic standby. Treatment of ACS, scope of revascularization, complications occurring during hospitalization and during one-year follow-up were analysed. The end points of the study were defined as death from all causes, cardiac death, ACS and the composite end point (death from cardiac causes and ACS recurrence).
RESULTS: In one-year follow-up, 11 patients died (7.2%), including 10 patients with MVD without complete revascularization. ACS recurrence occurred in 18 patients (12%), including 13 patients with MVD without complete revascularization. Significant stenosis of coronary arteries without ACS one-step intervention in patients with MVD was an important risk factor of all-cause mortality and a composite endpoint in comparison to patients with MVD who underwent complete revascularization (respectively: p=0.028, p=0.046) and to patients with single-vessel disease (respectively, p=0.006, p=0.003).
CONCLUSIONS: Incomplete revascularization in acute phase of ACS was associated with an increased risk of complications and a significantly increased risk of all-cause and cardiovascular death and recurrent ACS. One-step PCI of any significant stenoses in MVD patients resulted in better outcomes.
Authors:
Dariusz Luczak; Wojciech Majda; Rafał Dąbrowski; Ilona Kowalik; Sławomir Jasek; Cezary Sosnowski; Marek Kośmicki; Anna Mazurkiewicz; Hanna Szwed
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-02
Journal Detail:
Title:  Kardiologia polska     Volume:  -     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  -    
Other Details:
Languages:  POL     Pagination:  -     Citation Subset:  -    
Vernacular Title:
Znaczenie rokownicze zakresu rewaskularyzacji u chorych z ostrymi zespołami wieńcowymi i wielonaczyniową chorobą wieńcową w 1-rocznej obserwacji prospektywnej.
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