Jie Deng1,2, Xiaozeng Wang1, Yana Shi1, Xin Zhao1, Yaling Han1. 1. Department of Cardiology, The General Hospital of Shenyang Military Region, Chinese People's Liberation Army, Shenyang, China. 2. Department of Cardiology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Abstract
OBJECTIVE: It is not known if ACEF scores could evaluate the prognosis of recanalization of non-infarct-related coronary arteries (non-IRA) with chronic total occlusions (CTO) in patients who successfully underwent primary PCI. The objective of the current study was to assess the prognostic value of ACEF scores in acute ST-segment elevation myocardial infarction (STEMI) patients with non-IRA CTO after successful primary PCI. METHODS: There were 2952 STEMI patients who underwent successful primary PCI from January 2006 to December 2014 in our hospital, among them 377 patients had a non-IRA CTO lesion. The patients were divided into successful CTO-PCI group (n = 221) and failed/non-attempted CTO-PCI group (n = 156). Patients were stratified based on the ACEF tertiles. Primary end points measured in the current study were major adverse cardiac events (MACE) defined as the composite of all-cause death, nonfatal myocardial infarction, ischemia-driven coronary revascularization and hospitalization for heart failure at 1 year. RESULTS: The incidence of MACE, all-cause death and cardiac death were higher in the failed/non-attempted CTO-PCI group (P < 0.001). In the successful CTO-PCI group, the cumulative 1-year incidences of MACE and all-cause death were decreased compared to those in the failed/non-attempted CTO-PCI group (log-rank P < 0.001). The risk for MACE was reduced in the successful CTO-PCI group compared to the failed/non-attempted CTO-PCI group in patients with low and intermediate ACEF scores (log-rank P = 0.02). CONCLUSIONS: Successfully staged CTO-PCI could gain advantageous clinical outcomes in those patients with low or intermediate ACEF scores.
OBJECTIVE: It is not known if ACEF scores could evaluate the prognosis of recanalization of non-infarct-related coronary arteries (non-IRA) with chronic total occlusions (CTO) in patients who successfully underwent primary PCI. The objective of the current study was to assess the prognostic value of ACEF scores in acute ST-segment elevation myocardial infarction (STEMI) patients with non-IRA CTO after successful primary PCI. METHODS: There were 2952 STEMI patients who underwent successful primary PCI from January 2006 to December 2014 in our hospital, among them 377 patients had a non-IRA CTO lesion. The patients were divided into successful CTO-PCI group (n = 221) and failed/non-attempted CTO-PCI group (n = 156). Patients were stratified based on the ACEF tertiles. Primary end points measured in the current study were major adverse cardiac events (MACE) defined as the composite of all-cause death, nonfatal myocardial infarction, ischemia-driven coronary revascularization and hospitalization for heart failure at 1 year. RESULTS: The incidence of MACE, all-cause death and cardiac death were higher in the failed/non-attempted CTO-PCI group (P < 0.001). In the successful CTO-PCI group, the cumulative 1-year incidences of MACE and all-cause death were decreased compared to those in the failed/non-attempted CTO-PCI group (log-rank P < 0.001). The risk for MACE was reduced in the successful CTO-PCI group compared to the failed/non-attempted CTO-PCI group in patients with low and intermediate ACEF scores (log-rank P = 0.02). CONCLUSIONS: Successfully staged CTO-PCI could gain advantageous clinical outcomes in those patients with low or intermediate ACEF scores.
Authors: Pedro A Villablanca; Wilman Olmedo; Michael Weinreich; Tanush Gupta; Divyanshu Mohananey; Felipe N Albuquerque; Ibrahim Kassas; David Briceño; Cristina Sanina; Thomas A Brevik; Emily Ong; Harish Ramakrishna; Michael Attubato; Mark Menegus; Jose Wiley; Ankur Kalra Journal: J Am Heart Assoc Date: 2018-04-13 Impact factor: 5.501