Prognostic value of the age, creatinine, and ejection fraction score for non‐infarct‐related chronic total occlusion revascularization after primary percutaneous intervention in acute ST‐elevation myocardial infarction patients: A retrospective study

Wang, Xiaozeng; Shi, Yugen; Zhao, Xianxian; Han, Yaling

doi:10.1111/joic.12448

Cited by 14 publications

(13 citation statements)

References 26 publications

(66 reference statements)

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“…23,24 Lower levels of creatinine in patients with STEMI undergoing PCI could provide advantageous clinical outcomes. 25 The results of this current study showed that the rate of renal dysfunction in patients that underwent an invasive strategy was lower than that in patients that underwent conservative strategy. The creatinine level was negatively associated with whether to perform an invasive strategy in the current study.…”

Section: Discussionmentioning

confidence: 55%

A retrospective study of an invasive versus conservative strategy in patients aged ≥80 years with acute ST-segment elevation myocardial infarction

et al. 2019

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Objective To investigate what is the most appropriate strategy for patients with ST-segment elevation myocardial infarction (STEMI) aged ≥80 years in China. Methods This cohort study retrospectively enrolled patients with STEMI aged ≥80 years old and grouped them according to the treatment strategy that was used: a conservative treatment strategy or an invasive treatment strategy. Factors associated with whether to perform an invasive intervention, in-hospital death and a good prognosis were investigated using logistic regression analyses. Results A total of 232 patients were enrolled: conservative treatment group ( n = 93) and invasive treatment group ( n = 139). Patients in the invasive treatment group had a better prognosis and lower incidence of adverse events compared with the conservative treatment group. Advanced age, creatinine level and a higher Killip class were inversely correlated with whether to perform an invasive intervention, while the use of beta-receptor-blocking agents was a favourable factor for invasive treatment. Hypertension and a higher Killip class were risk factors for in-hospital death, while the use of beta-receptor-blocking agents and diuretics decreased the risk of in-hospital death. Conclusions An invasive treatment strategy was superior to a conservative treatment strategy in patients with STEMI aged ≥80 years.

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Section: Discussionmentioning

confidence: 55%

A retrospective study of an invasive versus conservative strategy in patients aged ≥80 years with acute ST-segment elevation myocardial infarction

et al. 2019

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“…The mean age of the participants was 58.58 ± 13.21 years. The usual age associated with a good outcome in percutaneous coronary intervention is 65 years [8]. In our case, the age of the participants was lesser and despite the age difference, the incidence of angina requiring revascularization (16%) was still higher.…”

Section: Discussionmentioning

confidence: 49%

Diurnal Variation in Outcomes of Percutaneous Coronary Intervention

Malik

Javed

2020

Cureus

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To determine whether the outcomes differ during regular hours as compared to off hours in patients with acute myocardial infarction who undergo primary percutaneous coronary intervention. Methods We conducted a prospective, interventional study of patients who presented to a specialized cardiac care center. Patients who satisfied the inclusion and exclusion criteria were included in the study. They were divided into two groups so that one group received intervention during regular working hours while the other group received intervention during 'off' hours. The data was collected through a self-constructed questionnaire. Cronbach's alpha was used to assess the internal consistency of the questionnaire, and it was found to be 0.75. The data obtained was analyzed on IBM's Statistical Package for the Social Sciences (SPSS) version 21.0 (IBM, Armonk, NY). Results Out of 100 participants, 64 (64%) were males and 36 (36%) were females. The mean age of the participants was 58.58 ± 13.21 years. Most (44%) of the patients were diabetic. Inferior wall myocardial infarcts were more common in our study. Percutaneous intervention during 'off' hours was associated with more adverse outcomes. The differences in gender and angina requiring revascularization were statistically significant (p-value<0.05). Conclusion No significant difference in outcomes was observed in both groups of patients. Metacentric data from different institutes should be gathered for a comprehensive insight on this topic where door-to-balloon times and initiation of catheterization lab procedures are practiced in different ways.

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“…Valenti et al confirmed the staged PCI of CTO in the non-IRA's role in improved cardiac survival at a 3-year follow-up in 1911 AMI patients [16]. Similarly, other 1year follow-up studies or retrospective studies agreed to the benefits of successfully staged revascularization of CTO in the non-IRA for AMI patients [8,17]. However, the multicentered EXPLORE study, the only randomized controlled trial that evaluated 302 patients with STEMI through a mean follow-up of 3.9 years, found no reduction of long-term MACCE [18].…”

Section: Discussionmentioning

confidence: 87%

“…Furthermore, in the CTO group, we identified that MVD could independently predict 11-year MACCE. CTO remains as the most challenging coronary lesion for PCI and requires optimal operating skills [8]. Data showed the prevalence of concurrent CTO in the non-IRA in STEMI patients varies from 4.7% to 31.5%, while its prevalence in NSTEMI patients ranged from 7.1% to 47% [7,[9][10][11].…”

Section: Discussionmentioning

confidence: 99%

The 11-Year Prognostic Impact of Chronic Total Occlusion in the Noninfarct-Related Coronary Artery on Patients with Acute Myocardial Infarction

Yang

Dou

et al. 2021

Journal of Interventional Cardiology

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Background. The prognostic significance of CTO in the non-IRA in patients with AMI has been under dispute. Relevant long-term follow-up studies are lacking. Hypothesis. CTO in the non-IRA is an independent predictor of poor long-term prognosis in patients with AMI. Methods. We prospectively enrolled 2336 patients with AMI who received emergent percutaneous coronary intervention successfully from January 2006 to May 2011. Our primary endpoints included death from cardiovascular causes, recurrent myocardial infarction, stroke, and target-vessel revascularization. We adopted Cox regression analysis adjusted for confounders to analyze the impact of CTO in the non-IRA on long-term mortalities. Results. We identified 628 (27.6%) subjects with CTO in the non-IRA among 2282 AMI patients. After a mean follow-up duration of 134.3 months, we found the CTO group had significantly higher MACCE rate than the group without CTO (30.4% versus 24.3%, P = 0.004 ). CTO in the non-IRA independently predicted 11-year MACCE in the male AMI subgroup (hazard ratio 1.28, 95% confidence interval 1.06 to 1.54, P = 0.01 ) and in the male NSTEMI subgroup (hazard ratio 1.53, 95% confidence interval 1.09 to 2.15, P = 0.02 ). In the CTO group, three-vessel disease independently predicted 11 year MACCE (hazard ratio 2.05, 95% confidence interval 1.29 to 3.28, P = 0.002 ). Conclusions. Our long-term observational study supported the association between CTO in the non-IRA and poorer prognosis in AMI patients undergoing primary PCI. We identified the group with the three-vessel disease as a high-risk subgroup in patients with CTO in the non-IRA.

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Prognostic value of the age, creatinine, and ejection fraction score for non‐infarct‐related chronic total occlusion revascularization after primary percutaneous intervention in acute ST‐elevation myocardial infarction patients: A retrospective study

Abstract: Successfully staged CTO-PCI could gain advantageous clinical outcomes in those patients with low or intermediate ACEF scores.

Cited by 14 publications

References 26 publications

A retrospective study of an invasive versus conservative strategy in patients aged ≥80 years with acute ST-segment elevation myocardial infarction

A retrospective study of an invasive versus conservative strategy in patients aged ≥80 years with acute ST-segment elevation myocardial infarction

Diurnal Variation in Outcomes of Percutaneous Coronary Intervention

The 11-Year Prognostic Impact of Chronic Total Occlusion in the Noninfarct-Related Coronary Artery on Patients with Acute Myocardial Infarction

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