Abstract | BACKGROUND: METHODS: We analyzed a multicenter all-comer AMI registry and identified 4748 patients between January 2004 and December 2009. Of these, 1894 patients were treated with PCI using a drug-eluting stent and had MR. The association between MR and the composite of major adverse cardiac and cerebrovascular events (MACCE; all-cause death, recurrent nonfatal myocardial infarction, stroke, and any revascularization) was examined. RESULTS: Patients with MR after the index PCI showed significantly higher cumulative incidence of MACCE compared with no-MR patients over the 5-year survival period (P=0.002). When the MR groups were compared on the basis of the severity of MR, ranging from mild to severe grades, a higher grade of MR was found to be associated with a higher incidence of MACCE (P<0.001). Multivariate Cox proportional hazard analysis revealed that no reflow, left-ventricular ejection fraction less than 50%, and anemia, in addition to MR, were consistently associated with increased all-cause death during the 5-year period (adjusted hazard ratio 1.408, 95% confidence interval 1.052-1.884, P=0.021). CONCLUSION: MR after AMI in patients successfully treated with primary PCI was associated with poor long-term outcome regardless of ST-segment elevation at diagnosis during the drug-eluting stent era.
|
Authors | Tae-Hoon Kim, Kwan Yong Lee, Young Choi, Ha-Wook Park, Young Soo Lee, Yoon Seok Koh, Hun-Jun Park, Pum-Joon Kim, Kiyuk Chang, Wook Sung Chung, Dong-Bin Kim, Sung-Ho Her, Chul Soo Park, Jong Min Lee, Hee-Yeol Kim, Ki Dong Yoo, Doo Soo Jeon, Youngkeun Ahn, Myung-Ho Jeong, Ki-Bae Seung |
Journal | Coronary artery disease
(Coron Artery Dis)
Vol. 27
Issue 2
Pg. 109-15
(Mar 2016)
ISSN: 1473-5830 [Electronic] England |
PMID | 26626143
(Publication Type: Journal Article)
|
Topics |
- Age Factors
- Aged
- Atrial Fibrillation
(epidemiology)
- Drug-Eluting Stents
- Female
- Humans
- Hypercholesterolemia
(epidemiology)
- Incidence
- Male
- Middle Aged
- Mitral Valve Insufficiency
(etiology)
- Mortality
- Myocardial Infarction
(complications, epidemiology, surgery)
- Myocardial Revascularization
(statistics & numerical data)
- No-Reflow Phenomenon
(epidemiology)
- Percutaneous Coronary Intervention
- Prognosis
- Proportional Hazards Models
- Recurrence
- Registries
- Retrospective Studies
- Risk Factors
- Stroke
(epidemiology)
- Stroke Volume
- Ventricular Dysfunction, Left
(etiology, physiopathology)
|