Prognostic impact of significant non-infarct-related left main coronary artery disease in patients with acute myocardial infarction who receive a culprit-lesion percutaneous coronary intervention

Title
Prognostic impact of significant non-infarct-related left main coronary artery disease in patients with acute myocardial infarction who receive a culprit-lesion percutaneous coronary intervention
Author(s)
김영조서석민[서석민]김태훈[김태훈]김찬준[김찬준]황병희[황병희]강민규[강민규]고윤석[고윤석]민진수[민진수]Kiyuk Chang[Kiyuk Chang]Pum joon Kim[Pum joon Kim]Hun jun Park[Hun jun Park]승기배[승기배]박승정[박승정]
Keywords
INTRAVASCULAR ULTRASOUND; BYPASS-SURGERY; SURGICAL REVASCULARIZATION; STENOSIS; REGISTRY; INTERMEDIATE; ANGIOPLASTY; ANGIOGRAPHY; PREDICTORS; SURVIVAL
Issue Date
201208
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
CORONARY ARTERY DISEASE, v.23, no.5, pp.307 - 314
Abstract
Background Infarct-related left main coronary artery disease (LMCAD) is associated with an increased cardiac mortality in the setting of acute myocardial infarction (AMI). However, the prevalence and prognostic impact of significant (>= 50% stenosis) non-infarct-related LMCAD in patients with AMI have not yet been elucidated. Methods We prospectively analyzed 7655 AMI patients who had undergone a percutaneous coronary intervention (PCI) in the Korea Acute Myocardial Infarction Registry from November 2005 to January 2008. We compared major adverse cardiac events (MACEs) in AMI patients with non-infarct-related LMCAD and those without LMCAD. Results Of 99 (1.3%) non-infarct-related LMCAD patients, 40 patients had undergone PCI due to their lesions on the left main coronary artery. The incidences of all-cause death, cardiac death, recurrent myocardial infarction, and composite of MACE except repeat revascularization were higher in patients with non-infarct-related LMCAD at 12 months. In Cox proportional hazard analysis for the prediction of MACE at 12 months, the hazard ratio of LMCAD was 2.189 (95% confidence interval 1.230-3.896, P = 0.008). In subgroup analysis, there was no significant cumulative difference between patients who had undergone non-infarct-related left main coronary artery PCI and those who did not undergo PCI at 1 and 12 months. Conclusion The significant, non-infarct-related LMCAD in patients with AMI remains a major adverse prognostic indicator even after receiving optimal culprit-lesion PCI. Coron Artery Dis 23:307-314 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
URI
http://hdl.handle.net/YU.REPOSITORY/27485http://dx.doi.org/10.1097/MCA.0b013e3283519f25
ISSN
0954-6928
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의과대학 > 내과학교실 > Articles
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