Predictors of recurrent acute myocardial infarction despite initially successful percutaneous coronary intervention: back to the basic

Abstract

play a role in re-MI development [8]. A recent, prospective observational study found that re-MI of a non-culprit vessel lesion was twice as re-MI in a culprit vessel. Thus, risk factor management (including GDMT) is important. Lee et al. [6] found that re-MI was significantly associated with diabetes mellitus, renal dysfunction, atypical chest pain, and multi-vessel disease; of these, all except chest pain are well known predictors of re-MI [9]. Notably, atypical chest pain was a statistically significant predictor of re-MI (odds ratio, 1.495; 95% confidence interval, 1.12.5 to 1.987; p = 0.006). Such pain is much more common in older and fragile patients, and those with multiple comorbidities [10,11].Although the cited study suggests that the independent predictors of re-AMI after successful PCI of index MI include diabetes, renal dysfunction, atypical chest pain, and multi-vessel disease, these risk factors are closely connected. Therefore, risk factor management (including GDMT) is important to reduce mortality in patients at high risk, even though PCI successfully treated the index MI.