Impact of the origin of the collateral feeding donor artery on short-term mortality in ST-elevation myocardial infarction with comorbid chronic total occlusion

Fujii, Toshiharu; Sakai, Katsuaki; Ohno, Yohei; Nakazawa, Gaku; Shinozaki, Norihiko; Matsukage, Takashi; Yoshimachi, Fuminobu; Ikari, Yuji

doi:10.1016/j.ijcard.2016.05.023

Cited by 19 publications

(9 citation statements)

References 21 publications

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“…The development of new severe ischemic events or reinfarction may further expand the ischemic area, resulting in heart failure, malignant arrhythmia, and even death. Therefore, the prognosis of patients with STEMI combined with MVD is worse than that of patients with culprit vessels only ( 2 , 38 , 39 ). Previous observational studies have shown that CR could improve short- and long-term mortality in STEMI patients with MVD; however, these results may be biased by different factors ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Complete Revascularization Strategies in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A Bayesian Network Meta-Analysis

Zhao

Guo

Huang

et al. 2021

Front. Cardiovasc. Med.

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Whether fractional flow reserve (FFR) should be available for revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) is controversial. We aimed to compare the efficacy of various complete revascularization (CR) regimens for STEMI patients with MVD. The PubMed and Cochrane Library databases and clinicaltrial.gov were searched for the randomized controlled trials (RCTs) comparing the FFR-guided CR, angiography-guided CR, and culprit-only revascularization (COR) strategies in STEMI patients with MVD. A Bayesian random-effect model was employed to synthesize the evidence in network meta-analysis. We used relative risk (RR) and 95% credible interval (CrI) as measures of effect size. The primary endpoint was the composite outcome of all-cause mortality or myocardial infarction (MI). Twelve RCTs were included. Angiography-guided CR showed a lower event rate of the composite outcome (RR, 0.68; 95%CrI, 0.50–0.87), all-cause mortality (RR, 0.75; 95%CrI, 0.55–0.96), MI (RR, 0.63; 95%CrI, 0.43–0.86), and repeat revascularization (RR, 0.36; 95% CrI, 0.24–0.55) compared with COR. Additionally, angiography-guided CR had a lower risk of primary outcome (RR, 0.64; 95%CrI, 0.38–0.94) and MI (RR, 0.58; 95%CrI, 0.31–0.92) than FFR-guided CR. The difference between the FFR-guided CR and COR in terms of composite outcome, all-cause mortality, and MI was similar. Angiography-guided CR was associated with the highest probability of optimal treatment for the primary outcome (98.5%), followed by FFR-guided CR (1.2%) and COR (0.3%). STEMI patients with MVD benefitted more from angiography-guided CR than from FFR-guided CR. However, only one study compared the effectiveness of FFR-guided and angiography-guided PCI; thus, the comparison between FFR-guided and angiography-guided PCI relied on indirect evidence. Therefore, further studies directly comparing the effectiveness of these two CR strategies are warranted.

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Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Complete Revascularization Strategies in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A Bayesian Network Meta-Analysis

Zhao

Guo

Huang

et al. 2021

Front. Cardiovasc. Med.

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“…The presence of a concomitant CTO in those patients with STEMI is responsible for a higher 30-day event rate and poor long-term prognosis ( 19 ). The prognosis especially deteriorates when the occluded vessel receives collateral flow from the IRA ( 20 ). In the HORIZONS-AMI trial reported by Claessen et al, patients with a non-IRA CTO were significantly less likely to achieve satisfactory postprocedural reperfusion flow and less frequently achieved complete ST-segment resolution than patients without a CTO ( 21 ).…”

Section: Poor Prognosis Of Coronary Chronic Total Occlusionmentioning

confidence: 99%

Revascularization of chronic total occlusion coronary artery and cardiac regeneration

Liao

Wang

et al. 2022

Front. Cardiovasc. Med.

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Coronary chronic total occlusion (CTO) contributes to the progression of heart failure in patients with ischemic cardiomyopathy. Randomized controlled trials demonstrated that percutaneous coronary intervention (PCI) for CTO significantly improves angina symptoms and quality of life but fails to reduce clinical events compared with optimal medical therapy. Even so, intervening physicians strongly support CTO-PCI. Cardiac regeneration therapy after CTO-PCI should be a promising approach to improving the prognosis of ischemic cardiomyopathy. However, the relationship between CTO revascularization and cardiac regeneration has rarely been studied, and experimental studies on cardiac regeneration usually employ rodent models with permanent ligation of the coronary artery rather than reopening of the occlusive artery. Limited early-stage clinical trials demonstrated that cell therapy for cardiac regeneration in ischemic cardiomyopathy reduces scar size, reverses cardiac remodeling, and promotes angiogenesis. This review focuses on the status quo of CTO-PCI in ischemic cardiomyopathy and the clinical prospect of cardiac regeneration in this setting.

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“…Tento fenomén "dvojího ohrožení" je způsoben současnou ischémií ve dvou koronárních povodích, které jsou závislé na dostatečném průtoku infarktovou tepnou (26,27 Obr. 9.…”

Section: Význam Cto U Pacientů S Akutním Koronárním Syndromemunclassified

Percutaneous coronary intervention of chronic total occlusion - to whom, when and why

Štípal¹,

Poloczek²,

Sůva³

et al. 2021

Vnitr Lek

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Impact of the origin of the collateral feeding donor artery on short-term mortality in ST-elevation myocardial infarction with comorbid chronic total occlusion

Cited by 19 publications

References 21 publications

Comparative Effectiveness of Complete Revascularization Strategies in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A Bayesian Network Meta-Analysis

Comparative Effectiveness of Complete Revascularization Strategies in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A Bayesian Network Meta-Analysis

Revascularization of chronic total occlusion coronary artery and cardiac regeneration

Percutaneous coronary intervention of chronic total occlusion - to whom, when and why

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