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Periprocedural myocardial infarction is not associated with an increased risk of long-term cardiac mortality after coronary bifurcation stenting.

Authors
Song, PS; Song, YB; Yang, JH; Kang, GH; Hahn, JY; Choi, SH; Choi, JH; Lee, SH; Jang, Y; Yoon, JH; Tahk, SJ; Seung, KB; Park, SJ; Gwon, HC
Citation
International journal of cardiology, 167(4):1251-1256, 2013
Journal Title
International journal of cardiology
ISSN
0167-52731874-1754
Abstract
BACKGROUND: Debate continues over the importance of periprocedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). We evaluated the prognostic significance of PMI in patients undergoing PCI for bifurcation lesions.



METHODS: Between January 2004 and June 2006, patients from 16 centers who received non-left main bifurcation lesion PCIs were enrolled. PMI was defined as a peak creatine kinase-myocardial band (CK-MB) ≥ 3 times the upper limit of normal after PCI. We compared long-term cardiac mortality between patients with and without PMI.



RESULTS: Among the 1188 patients, PMI occurred in 119 (10.0%). Left ventricular ejection fraction<50% (adjusted hazard ratio [HR]: 2.08, 95% confidence interval [CI]: 1.13-3.82, p=0.018), multi-vessel coronary artery disease (adjusted HR: 2.28, 95% CI: 1.36-3.81, p=0.002), and PCI-related acute closure in a side branch (adjusted HR: 3.34, 95% CI: 1.23-9.02, p=0.018) were the significant risk factors for PMI. During the median follow-up of 22.7 months, the unadjusted rate of long-term cardiac mortality was significantly higher in patients with PMI than in those without PMI (2.5% vs. 0.7%, p=0.026). After multivariable adjustment, the relationship between PMI and short-term (≤ 30 day) cardiac mortality was significant (adjusted HR: 12.32, 95% CI: 1.07-141.37, p=0.044). However, PMI was not an independent prognostic factor of long-term cardiac mortality (adjusted HR: 2.59, 95% CI: 0.62-10.85, p=0.20).



CONCLUSIONS: PMI occurs in patients with a higher prevalence of adverse cardiac risks and predicts short-term but not long-term cardiac mortality in patients undergoing bifurcation lesion PCI.
MeSH terms
AgedCoronary Artery Disease/*mortality/surgery*Drug-Eluting Stents/adverse effectsFemaleFollow-Up StudiesHumansMaleMiddle AgedMyocardial Infarction/*diagnosis/*mortality/surgery*Preoperative PeriodRegistriesRisk FactorsTime FactorsTreatment Outcome
DOI
10.1016/j.ijcard.2012.03.146
PMID
22494861
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
탁, 승제
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