Document Detail


Predictors of nonoptimal coronary flow after primary percutaneous coronary intervention with stent implantation for acute myocardial infarction.
MedLine Citation:
PMID:  20206075     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Predictors of suboptimal coronary flow in the infarct-related artery (IRA) after stent-based primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) have not been fully investigated. METHODS AND RESULTS: Using the AMI-Kyoto Multi-Center Risk Study database, we retrospectively compared clinical manifestations and in-hospital prognosis between AMI patients undergoing stent-based primary PCI with final Thrombolysis In Myocardial Infarction (TIMI) grade < or = 2 in the IRA (nonoptimal group, n=69) and those with final TIMI grade 3 (optimal group, n=1200). The nonoptimal group had higher prevalence of Killip class > or = 3 at admission, higher frequency of mechanical support devices during procedures, larger value of maximal creatine phosphokinase, and a significantly higher in-hospital mortality rate (27.5% for nonoptimal vs. 9.0% for optimal, P<0.001), compared with the optimal group. On multivariate analysis, Killip class > or = 3 at admission was the independent predictor of the final nonoptimal flow (odds ratio 2.33, 95% confidence intervals 1.27-4.26 P=0.006), but TIMI 3 flow before primary PCI and elapsed time (symptom onset-to-admission time)<24h were not. CONCLUSIONS: Killip class > or = 3 at admission is an independent predictor of the final nonoptimal flow in AMI patients undergoing primary PCI with stent implantation.
Authors:
Jun Shiraishi; Yoshio Kohno; Takahisa Sawada; Mitsuo Takeda; Masayasu Arihara; Masayuki Hyogo; Takatomo Shima; Takashi Okada; Takeshi Nakamura; Satoaki Matoba; Hiroyuki Yamada; Akiyoshi Matsumuro; Takeshi Shirayama; Makoto Kitamura; Keizo Furukawa; Hiroaki Matsubara;
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-12-16
Journal Detail:
Title:  Journal of cardiology     Volume:  55     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  217-23     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Cardiology, Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto 605-0981, Japan. sjun@msj.biglobe.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography
Coronary Circulation / physiology*
Creatine Kinase / blood
Female
Humans
Male
Myocardial Infarction / mortality,  physiopathology,  therapy*
Myocardial Reperfusion
Retrospective Studies
Risk Factors
Stents*
Chemical
Reg. No./Substance:
EC 2.7.3.2/Creatine Kinase
Investigator
Investigator/Affiliation:
K Matsubara / ; M Shima / ; M Kiyama / ; N Nakajima / ; H Miyanaga / ; T Nakagawa / ; H Matsui / ; Y Kunieda / ; H Fujita / ; K Inoue / ; A Matsuo / ; T Sakatani / ; Y Tsubakimoto / ; C Yamada / ; Y Oda / ; S Tanabe / ; T Tatsumi / ; N Keira / ; S Nishikawa / ; T Nomura / ; K Shiga / ; Y Kohno / ; Y Adachi / ; H Yokoi / ; T Kuriyama / ; R Matsuo / ; Y Harada / ; T Hikosaka / ; T Nakagami / ; Y Yamahara / ; K Ishibashi / ; R Sakai / ; K Akashi / ; T Yamamoto / ; N Kinoshita / ; H Irie / ; R Nakamura / ; M Nishio / ; T Sakamoto / ; H Hayashi / ; S Matsunaga / ; S Kimura / ; K Isodono / ; S Honsho / ; M Tagawa / ; H Takada / ; A Matsui / ; M Ariyoshi / ; M Kimura / ; T Takahashi / ; H Shiraishi / ; T Yamano /

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