Long-term impact of multivessel disease on cause-specific mortality after ST elevation myocardial infarction treated with reperfusion therapy.

Heart
René J van der SchaafJ-H E Dambrink

Abstract

To investigate the long-term impact of multivessel coronary artery disease (MVD) on cause-specific mortality in patients with ST elevation myocardial infarction (STEMI) treated with reperfusion therapy. Patients with STEMI (n = 395) treated with primary angioplasty or thrombolysis in the setting of a randomised clinical trial were enrolled in the study. Follow up was 8 (2) years. For patients who died all available records were reviewed to assess the specific cause of death. MVD was present in 57% of patients. Patients with MVD were older and more of them had diabetes and previous myocardial infarction. Compared with the non-MVD group, residual left ventricular ejection fraction was lower (45.9% v 49.6%, p = 0.001) and total mortality was higher in patients with MVD (32% v 19%, p = 0.002). After adjustment for potential confounders this association was not significant (hazard ratio 1.4, 95% confidence interval (CI) 0.9 to 2.2). When the specific cause of death was considered, sudden death was comparable between patients with and without MVD (10% v 8%, p = 0.49) but death caused by heart failure was significantly higher in patients with MVD (hazard ratio 7.4, 95% CI 1.7 to 32.2). Patients with STEMI and MVD have a higher long-te...Continue Reading

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Citations

Jun 12, 2010·The American Journal of Cardiology·Niels J W VeroudenRobbert J de Winter
Sep 15, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Aldo RuggieriPasquale Assennato
Apr 18, 2015·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·S RasoulJ C A Hoorntje
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Jun 7, 2014·Circulation Research·Akshay BagaiChristopher B Granger
Jul 12, 2017·Coronary Artery Disease·Janarthanan Sathananthan, Vladimír Džavík
Apr 3, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Hans-Josef FeistritzerHolger Thiele
Feb 7, 2021·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Luigi Di SerafinoGiovanni Esposito
Jul 22, 2021·Journal of Cardiovascular Translational Research·Jill K BadinMichael Sturek

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