Document Detail


Percutaneous coronary intervention for nonculprit vessels in cardiogenic shock complicating ST-segment elevation acute myocardial infarction.
MedLine Citation:
PMID:  24105454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We investigated the clinical impact of multivessel percutaneous coronary intervention in ST-segment elevation myocardial infarction complicated by cardiogenic shock with multivessel disease.
DESIGN: A prospective, multicenter, observational study.
SETTING: Cardiac ICU of a university hospital.
PATIENTS: Between November 2005 and September 2010, 338 patients were selected. Inclusion criteria were as follows: 1) ST-segment elevation myocardial infarction with cardiogenic shock and 2) multivessel disease with successful primary percutaneous coronary intervention for the infarct-related artery. Patients were divided into multivessel percutaneous coronary intervention and culprit-only percutaneous coronary intervention.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Primary outcome was all-cause mortality. Median follow-up duration was 224 days (interquartile range, 46-383 d). Multivessel percutaneous coronary intervention was performed during the primary percutaneous coronary intervention in 60 patients (17.8%). In-hospital mortality was similar in both groups (multivessel percutaneous coronary intervention vs culprit-only percutaneous coronary intervention, 31.7% vs 24.5%; p = 0.247). All-cause mortality during follow-up was not significantly different between the two groups after adjusting for patient, angiographic, and procedural characteristics as well as propensity scores for receiving multivessel percutaneous coronary intervention (35.0% vs 30.6%; adjusted hazard ratio, 1.06; 95% CI, 0.61-1.86; p = 0.831). There were no significant differences between the groups in rates of major adverse cardiac events (41.7% vs 37.1%; adjusted hazard ratio, 1.03; 95% CI, 0.62-1.71; p = 0.908) and any revascularization (6.7% vs 4.7%; adjusted hazard ratio, 1.88; 95% CI, 0.51-6.89; p = 0.344).
CONCLUSIONS: Multivessel percutaneous coronary intervention could not reduce the prevalence of mortality in patients with cardiogenic shock complicating ST-segment elevation myocardial infarction and multivessel disease during primary percutaneous coronary intervention.
Authors:
Jeong Hoon Yang; Joo-Yong Hahn; Pil Sang Song; Young Bin Song; Seung-Hyuk Choi; Jin-Ho Choi; Sang Hoon Lee; Myung-Ho Jeong; Dong-Joo Choi; Young Jo Kim; Hyeon-Cheol Gwon
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Publication Detail:
Type:  Journal Article; Multicenter Study; Observational Study    
Journal Detail:
Title:  Critical care medicine     Volume:  42     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2013-12-18     Completed Date:  2014-02-19     Revised Date:  2014-08-28    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  17-25     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Vessels / surgery
Female
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  mortality,  surgery
Percutaneous Coronary Intervention / methods*
Propensity Score
Prospective Studies
Shock, Cardiogenic / etiology,  mortality,  surgery*
Treatment Outcome
Comments/Corrections
Comment In:
Crit Care Med. 2014 Aug;42(8):e601-2
Crit Care Med. 2014 Jan;42(1):192-4   [PMID:  24346521 ]
Crit Care Med. 2014 Aug;42(8):e601-2   [PMID:  25029155 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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