Document Detail

Prognostic impact of significant non-infarct-related left main coronary artery disease in patients with acute myocardial infarction who receive a culprit-lesion percutaneous coronary intervention.
MedLine Citation:
PMID:  22527385     Owner:  NLM     Status:  Publisher    
BACKGROUND: Infarct-related left main coronary artery disease (LMCAD) is associated with an increased cardiac mortality in the setting of acute myocardial infarction (AMI). However, the prevalence and prognostic impact of significant (≥50% stenosis) non-infarct-related LMCAD in patients with AMI have not yet been elucidated. METHODS: We prospectively analyzed 7655 AMI patients who had undergone a percutaneous coronary intervention (PCI) in the Korea Acute Myocardial Infarction Registry from November 2005 to January 2008. We compared major adverse cardiac events (MACEs) in AMI patients with non-infarct-related LMCAD and those without LMCAD. RESULTS: Of 99 (1.3%) non-infarct-related LMCAD patients, 40 patients had undergone PCI due to their lesions on the left main coronary artery. The incidences of all-cause death, cardiac death, recurrent myocardial infarction, and composite of MACE except repeat revascularization were higher in patients with non-infarct-related LMCAD at 12 months. In Cox proportional hazard analysis for the prediction of MACE at 12 months, the hazard ratio of LMCAD was 2.189 (95% confidence interval 1.230-3.896, P=0.008). In subgroup analysis, there was no significant cumulative difference between patients who had undergone non-infarct-related left main coronary artery PCI and those who did not undergo PCI at 1 and 12 months. CONCLUSION: The significant, non-infarct-related LMCAD in patients with AMI remains a major adverse prognostic indicator even after receiving optimal culprit-lesion PCI.
Suk Min Seo; Tae-Hoon Kim; Chan Jun Kim; Byung Hee Hwang; Min Kyu Kang; Yoon Seok Koh; Jinsoo Min; Kiyuk Chang; Pum Joon Kim; Hun Jun Park; Wook Sung Chung; Myung Ho Jeong; Young Jo Kim; Seung Jung Park; Ki-Bae Seung
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-18
Journal Detail:
Title:  Coronary artery disease     Volume:  -     ISSN:  1473-5830     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
aCardiovascular Center and Cardiology Division, Incheon St Mary's Hospital, The Catholic University of Korea, Incheon bCardiovascular Center and Cardiology Division, Seoul St Mary's Hospital, The Catholic University of Korea cCardiovascular Center and Cardiology Division, Seoul Asan Medical Center, The Ulsan University of Korea, Seoul dCardiovascular Center and Cardiology Division, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijeongbu eCardiovascular Center and Cardiology Division, Chonnam National University Hospital, The Chonnam National University of Korea, Guangju fCardiovascular Center and Cardiology Division, Yeungnam University Hospital, The Yeungnam University of Korea, Daegu, Republic of Korea.
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