Importance of complete revascularization in patients with acute myocardial infarction treated with percutaneous coronary intervention

Kalarus, Zbigniew; Lenarczyk, Radosław; Kowalczyk, Jacek; Kowalski, Oskar; Gąsior, Mariusz; Wąs, Tomasz; Zębik, Tadeusz; Krupa, Hubert; Chodór, Piotr; Poloński, Lech; Zembala, Marian

doi:10.1016/j.ahj.2006.10.033

Cited by 77 publications

(55 citation statements)

References 17 publications

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“…13 In contrast, another recent report has shown that in AMI patients with multivessel disease, multivessel PCI was not associated with additional death and MACE, compared with PCI in the infarct-related artery alone, 14 and another recent study has also pointed out that incomplete revascularization was a significant and independent risk of death and MACE, particularly in AMI patients with lowered ejection fraction, impaired renal function, or diabetes mellitus. 15 Our study has also demonstrated that the presence of multivessel disease or diseased LMT on initial CAG was an independent positive predictor of in-hospital death in the repeat-MI patients, a subgroup of high-risk patients with AMI, but not in the first-MI patients. Further prospective and long-term follow-up studies are necessary to ascertain the determinants of prognosis in patients with recurrent MI and to evaluate the safety and efficacy of multivessel PCI or early staged PCI in this population.…”

Section: Circulation Journal Vol72 August 2008mentioning

confidence: 70%

“…9,11,12 However, the role of multivessel PCI or early staged PCI in AMI patients with multivessel disease during the index hospital stay remains controversial. [13][14][15] A recent report from Corpus et al indicated that in AMI patients with multivessel disease, multivessel PCI was associated with higher frequency of re-infarction, revascularization, and major adverse cardiac events (MACE), compared with PCI restricted to the infarct-related artery alone, suggesting that in AMI patients with multivessel disease, PCI should be performed for the infarct-related artery alone during the index hospital stay. 13 In contrast, another recent report has shown that in AMI patients with multivessel disease, multivessel PCI was not associated with additional death and MACE, compared with PCI in the infarct-related artery alone, 14 and another recent study has also pointed out that incomplete revascularization was a significant and independent risk of death and MACE, particularly in AMI patients with lowered ejection fraction, impaired renal function, or diabetes mellitus.…”

Section: Circulation Journal Vol72 August 2008mentioning

confidence: 99%

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Predictors of In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Recurrent Myocardial Infarction

Shiraishi

Kohno

Sawada

et al. 2008

Circ J

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epeat acute myocardial infarction (AMI) is a deteriorated condition with high in-hospital morbidity and mortality, which can be attributed to the frequent coexistence of multivessel disease and shock. Previous accumulating evidence shows that primary percutaneous coronary intervention (PCI) can improve the prognosis of AMI complicated with cardiogenic shock, 1-4 although a recent report indicated that previous myocardial infarction (MI), older age, and failed reperfusion were independent predictors of in-hospital death in AMI patients with cardiogenic shock. 5 However, the clinical manifestations and the predictors of in-hospital prognosis of repeat AMI patients Circulation Journal Vol.72, August 2008 undergoing primary PCI remain to be elucidated. The AMIKyoto Multi-Center Risk Study, a large multicenter observational study in which 16 collaborating hospitals in Kyoto Prefecture have collected demographic, procedural, and outcome data on AMI patients, was established in 2000 in order to analyze these data and establish an emergencyhospital network for heart diseases in Kyoto. [6][7][8][9] The purpose of the present study was to compare clinical background, in-hospital prognosis, and determinants of in-hospital outcome in recurrent AMI patients undergoing primary PCI with those of first AMI patients undergoing primary PCI, using data from the AMI-Kyoto Multi-Center Risk Study. Methods Patient PopulationFrom January 2000 to December 2005, 2,230 consecutive patients with a diagnosis of AMI who were admitted to AMI-Kyoto Multi-Center Risk Study Group Hospitals within 1 week after the onset of AMI, were enrolled in the present study. Of these, 328 patients had previous MI, and 1,817 patients underwent primary PCI, of whom data on clinical background were available in 1,785. Previous MI was identified by medical history and echocardiographic findings. We retrospectively compared clinical background, coronary Background Recurrent acute myocardial infarction (AMI) is a deteriorated condition with high in-hospital morbidity and mortality, but the predictors of in-hospital outcome after primary percutaneous coronary intervention (PCI) for repeat AMI remain unclear. Methods and ResultsUsing the AMI-Kyoto Multi-Center Risk Study database, clinical background, angiographic findings, results of primary PCI, and in-hospital prognosis were retrospectively compared between primary PCI-treated AMI patients with previous myocardial infarction (MI) (repeat-MI patients, n=235) and those without previous MI (first-MI patients, n=1,550). The repeat-MI patients had higher prevalence of Killip class ≥3 at admission, larger number of diseased vessels, and a significantly higher in-hospital mortality rate than the first-MI patients. On multivariate analysis, number of diseased vessels ≥2 or diseased left main trunk (LMT) on initial coronary angiography was the independent positive predictor of in-hospital mortality in the repeat-MI patients, not in the first-MI patients, whereas acquisition of Thrombolysis In Myocardial Infarction 3 f...

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Section: Circulation Journal Vol72 August 2008mentioning

confidence: 70%

Section: Circulation Journal Vol72 August 2008mentioning

confidence: 99%

Predictors of In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Recurrent Myocardial Infarction

Shiraishi

Kohno

Sawada

et al. 2008

Circ J

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“…PCI of the infarct-related artery was performed following diagnostic angiography. The goal of PCI was to restore thrombolysis in myocardial infarction flow grade 3 with residual stenosis lower than 30%, which denotes a successful procedure [21,23]. After the intervention, all patients continued to receive 150 mg of aspirin once daily indefinitely, and a loading dose of 300–600 mg of clopidogrel just before PCI was followed by 75 mg of clopidogrel once daily.…”

Section: Methodsmentioning

confidence: 99%

“…Complete revascularization was defined when no total occlusion and no residual stenosis >70% (for left main >50%) was found in any major coronary artery or their major branches at discharge [23]. …”

Section: Methodsmentioning

confidence: 99%

Prognostic Significance of Hyperuricemia in Patients with Different Types of Renal Dysfunction and Acute Myocardial Infarction Treated with Percutaneous Coronary Intervention

Kowalczyk

Francuz²,

Swoboda³

et al. 2010

Nephron Clin Pract

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Aim: This study evaluated the impact of hyperuricemia (HUR) on outcome in patients with different types of impaired renal function (IRF) and acute myocardial infarction (AMI) treated invasively. Methods: Out of 3,593 consecutive AMI patients treated invasively, 1,015 IRF patients were selected. The IRF group consisted of patients with baseline kidney dysfunction (BKD group) and/or patients with contrast-induced nephropathy (CIN group). HUR was defined as a serum uric acid concentration (SUAC) >420 µmol/l (>7 mg/dl). Independent predictors of death and major adverse cardiovascular events (MACE) were selected by the multivariate Cox-regression model. Results: Remote mortality rates were higher in HUR patients: IRF (32.7 vs. 18.6%), BKD (41.3 vs. 25.9%), CIN (35.4 vs. 16.7%); all p < 0.001. HUR was an independent predictor of death in BKD (hazard ratio (HR) 1.38, p < 0.05). Each 100-µmol/l increase in SUAC was associated with a significant increase of HR for mortality: 1.087 in IRF patients, 1.108 in BKD patients, 1.128 in CIN patients; all p < 0.05. Remote major adverse cardiovascular event rates were higher in HUR patients: IRF (55.4 vs. 48.9%), CIN (56.8 vs. 48%); both p < 0.05. Conclusions: In AMI patients treated invasively, an increase in SUAC is an independent predictor of death within all types of renal dysfunction; HUR defined as SUAC >420 µmol/l (>7 mg/dl) is a predictor only in BKD patients.

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“…CR is relevant to the extent that CR improves clinical outcomes. However, the clinical benefits of CR using angiographic criteria are uncertain, with some [65,[67][68][69][70] but not all [71][72][73] studies reporting superior outcomes with CR. CR does reduce the incidence of subsequent CABG [66,74] or subsequent PCI [64] (Table II).…”

Section: Strategies For Multivessel Pci Complete Versus Incomplete Rementioning

confidence: 99%

Staging of multivessel percutaneous coronary interventions: An expert consensus statement from the Society for Cardiovascular Angiography and Interventions

Blankenship

Moussa

Chambers

et al. 2011

Cathet Cardio Intervent

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Percutaneous coronary interventions (PCIs) to treat multivessel coronary artery disease (MVCAD) may involve single-vessel or multivessel interventions, performed in one or more stages. This consensus statement reviews factors that may influence choice of strategy and includes six recommendations to guide decisions regarding staging of PCI [1]. Every patient who undergoes PCI should receive optimal therapy for coronary disease, ideally before starting the procedure [2]. Multivessel PCI at the time of diagnostic catheterization should be considered only if informed consent included the risks and benefits of multivessel PCI and the risks and benefits of alternative treatments [3]. When considering multivessel PCI, the interventionist should develop a strategy regarding which stenoses to treat or evaluate, and their order, method, and timing. This strategy should maximize patient benefits, minimize patient risk, and consider the factors described in this article [4]. For planned multivessel PCI, additional vessel(s) should be treated only if the first vessel is treated successfully and if anticipated contrast and radiation doses and patient and operator conditions are favorable [5]. After the first stage of the planned multistage PCI, the need for subsequent PCI should be reviewed before it is performed [6]. Third party payers and quality auditors should recognize that multistage PCI for MVCAD is neither an indication of poor quality nor an attempt to increase reimbursement when performed according to recommendations in this article.V C 2011 Wiley Periodicals, Inc.

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Importance of complete revascularization in patients with acute myocardial infarction treated with percutaneous coronary intervention

Cited by 77 publications

References 17 publications

Predictors of In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Recurrent Myocardial Infarction

Predictors of In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Recurrent Myocardial Infarction

Prognostic Significance of Hyperuricemia in Patients with Different Types of Renal Dysfunction and Acute Myocardial Infarction Treated with Percutaneous Coronary Intervention

Staging of multivessel percutaneous coronary interventions: An expert consensus statement from the Society for Cardiovascular Angiography and Interventions

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