Caroline E Veltman1, Bas L van der Hoeven2, Georgette E Hoogslag2, Helèn Boden2, Rohit K Kharbanda2, Michiel A de Graaf1, Victoria Delgado2, Erik W van Zwet3, Martin J Schalij2, Jeroen J Bax2, Arthur J H A Scholte4. 1. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands The Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands. 2. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands. 3. Biomedical Statistics, Leiden University Medical Center, Leiden, the Netherlands. 4. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands a.j.h.a.scholte@lumc.nl.
Abstract
AIMS: Prognostic importance of coronary vessel dominance in patients with ST-elevation myocardial infarction (STEMI) remains uncertain. The aim of this study was to assess influence of coronary vessel dominance on the short- and long-term outcome after STEMI. METHODS AND RESULTS: Coronary angiographic images of consecutive patients presenting with first STEMI were retrospectively reviewed to assess coronary vessel dominance. Patients were followed after STEMI during a median period of 48 (IQR38-61) months for the occurrence of all-cause mortality and the composite of reinfarction and cardiac death. The population comprised 1131 patients of which 971 (86%) patients had a right dominant, 102 (9%) a left dominant, and 58 (5%) a balanced system. After 5 years of follow-up, the cumulative incidence of all-cause mortality was significantly higher in patients with a left dominant system, compared with a right dominant and balanced system (log-rank P = 0.013). Moreover, a left dominant system was an independent predictor for 30-day mortality (OR 2.51, 95% CI 1.11-5.67, P = 0.027) and the composite of reinfarction and cardiac death within 30-days after STEMI (OR 2.25, 95% CI 1.09-4.61, P = 0.028). In patients surviving first 30-days post-STEMI, coronary vessel dominance had no influence on long-term outcome. CONCLUSIONS: A left dominant coronary artery system is associated with a significantly increased risk of 30-day mortality and early reinfarction after STEMI. After surviving the first 30-days post-STEMI, coronary vessel dominance had no influence on long-term outcome. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Prognostic importance of coronary vessel dominance in patients with ST-elevation myocardial infarction (STEMI) remains uncertain. The aim of this study was to assess influence of coronary vessel dominance on the short- and long-term outcome after STEMI. METHODS AND RESULTS: Coronary angiographic images of consecutive patients presenting with first STEMI were retrospectively reviewed to assess coronary vessel dominance. Patients were followed after STEMI during a median period of 48 (IQR38-61) months for the occurrence of all-cause mortality and the composite of reinfarction and cardiac death. The population comprised 1131 patients of which 971 (86%) patients had a right dominant, 102 (9%) a left dominant, and 58 (5%) a balanced system. After 5 years of follow-up, the cumulative incidence of all-cause mortality was significantly higher in patients with a left dominant system, compared with a right dominant and balanced system (log-rank P = 0.013). Moreover, a left dominant system was an independent predictor for 30-day mortality (OR 2.51, 95% CI 1.11-5.67, P = 0.027) and the composite of reinfarction and cardiac death within 30-days after STEMI (OR 2.25, 95% CI 1.09-4.61, P = 0.028). In patients surviving first 30-days post-STEMI, coronary vessel dominance had no influence on long-term outcome. CONCLUSIONS: A left dominant coronary artery system is associated with a significantly increased risk of 30-day mortality and early reinfarction after STEMI. After surviving the first 30-days post-STEMI, coronary vessel dominance had no influence on long-term outcome. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Maros Ferencik; Karol M Pencina; Ting Liu; Khristine Ghemigian; Kristin Baltrusaitis; Joseph M Massaro; Ralph B D'Agostino; Christopher J O'Donnell; Udo Hoffmann Journal: Circ Cardiovasc Imaging Date: 2017-10 Impact factor: 7.792
Authors: Gert Klug; Hans-Josef Feistritzer; Sebastian J Reinstadler; Martin Reindl; Christina Tiller; Magdalena Holzknecht; Agnes Mayr; Silvana Müller; Axel Bauer; Bernhard Metzler Journal: Int J Cardiovasc Imaging Date: 2019-11-09 Impact factor: 2.357