Title: Impact of primary PCI on early and long-term outcomes in patients with ST-elevation myocardial infarction combined with chronic total occlusion of non-infarct related artery
Abstract: Objective To discuss the clinical characteristics of ST-elevation myocardial infarction(STEMI) combined with chronic total occlusion of non-infarct-related artery(non-IRA),and to assess the therapeutic effect of primary percutaneous coronary intervention(PCI).Methods This study included 360 consecutive patients with STEMI who underwent primary PCI within the first 12 hours after the onset of symptom.Of them,47 patients(Group A) had at least one chronic total occlusion(CTO) vessel of non-IRA,while the remaining 313 patients(Group B) showed no CTO vessels of non-IRA.Clinical characteristics,PCI procedural features,outcomes during hospitalization and follow-up results were compared between two groups.Results Compared with Group B,patients in Group A had more diabetes(25.5% vs 14.1%,P = 0.043) and previous myocardial infarction history(10.6% vs 3.2%,P = 0.017).During PCI procedure,intraaortic balloon pump(IABP) was more often used in group A than in group B(21.3% vs 10.9%,P = 0.042).Similarly,temporary cardiac pacing(38.3% vs 21.1%,P = 0.009) and electrical cardioversion(21.3% vs 6.4%,P = 0.001) were more frequently performed in Group A than in Group B.But technical success rate(93.6% vs 94.6%) and in-hospital mortality rate(6.4% vs 5.4%,P 0.05) showed no significant difference between two groups.During the follow-up period(average 42 months),occurrence of heart failure was significantly higher(21.3% vs 10.9%,P = 0.042) in Group A than in Group B,however no significant difference in mortality rate existed between two groups(4.3% vs 5.8%,P 0.05).Conclusion Despite serious clinical conditions,patients with STEMI and CTO of at least one non-infarct-related artery can obtain a satisfactory short-term and long-term effectiveness if primary PCI procedure can be carried out with the help of circulatory and electrophy-siological support.
Publication Year: 2010
Publication Date: 2010-01-01
Language: en
Type: article
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