Influence of previous myocardial infarction site on in-hospital outcome after primary percutaneous coronary intervention for repeat myocardial infarction

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• 作者：Jun Shiraishi ; Yoshio Kohno ; Takahisa Sawada ; Mitsuo Takeda ; Masayasu Arihara ; Masayuki Hyogo ; Takatomo Shima ; Takashi Okada ; Takeshi Nakamura ; Satoaki Matoba ; Hiroyuki Yamada ; Akiyoshi Matsumuro ; Tak
• 关键词：Prognosis ; Primary percutaneous coronary intervention ; Recurrent myocardial infarction
• 刊名：Journal of Cardiology
• 出版年：2010
• 出版时间：January 2010
• 年：2010
• 卷：55
• 期：1
• 页码：77-83
• 全文大小：257 K

文摘

Summary

Background

Recurrent acute myocardial infarction (AMI) is a disastrous condition with high in-hospital morbidity and mortality. However, the relation between location of previous myocardial infarction (MI) and in-hospital outcome in repeat-AMI patients undergoing primary percutaneous coronary intervention (PCI) remains unclear.

Methods and results

Using the AMI-Kyoto Multi-Center Risk Study database, clinical background, angiographic findings, results of primary PCI, and in-hospital prognosis were retrospectively compared between primary PCI-treated AMI patients with previous anterior MI (anterior group, n = 151) and those with previous non-anterior MI (non-anterior group, n = 157). Clinical backgrounds, angiographic findings, results of primary PCI, and in-hospital outcome did not differ significantly between the two groups. On multivariate analysis, Killip class ≥3 at admission, number of diseased vessels ≥2 or diseased left main trunk at initial coronary angiography, and age were the independent predictors of in-hospital mortality in the recurrent-AMI patients, but not the anterior location of previous MI.

Conclusions

These results suggest that among recurrent-AMI patients undergoing primary PCI, in-hospital prognosis mostly depends on the severity of acute heart failure at the onset and the residual myocardial ischemia rather than previous MI sites.