Prediction of one-year mortality among 30-day survivors after primary percutaneous coronary interventions.
Publication/Presentation Date
3-15-2006
Abstract
Little information exists on the features that influence risk factors for death at 1 year among 30-day survivors of ST-elevation myocardial infarction (STEMI) that is treated with primary percutaneous coronary intervention (PCI). Accordingly, we examined 3,280 patients with STEMI who were enrolled in Stent-PAMI and CADILLAC trials, were treated with primary PCI, and survived >30 days after STEMI. Death at 1 year occurred in 74 patients (2.3%) who survived >30 days after their index STEMI. Patients who died at 1 year were more likely to be older and women and have lower body weight and greater prevalence of previous stroke. Similarly, the sum of ST elevations, 3-vessel or left anterior coronary disease, and final Thrombolysis In Myocardial Infarction gradehigher, whereas left ventricular ejection fraction was lower among patients who died versus those who survived. The multivariate logistic regression model identified age >70 years (odds ratio [OR] 3.3 95% confidence interval [CI] 1.9 to 5.7), weight(OR 1.9, 95% CI 1.1 to 3.6), any tachyarrhythmia during index hospitalization (defined as ventricular or supraventricular tachycardia that required treatment) (OR 2.4, 95% CI 1.2 to 4.8), number of diseased coronary arteries (OR 1.5, 95% CI 1.1 to 2.1), and left ventricular ejection fraction (each 10% decrease, OR 1.5, 95% CI 1.2 to 1.8) as factors independently associated with risk of death at 1 year among 30-day survivors. In conclusion, our study provides a method for clinicians to advise patients who are treated with primary PCI and survive the acute phase of STEMI with regard to patients' long-term prognosis, thus enhancing planning and setting up of realistic expectations.
Volume
97
Issue
6
First Page
817
Last Page
822
ISSN
0002-9149
Published In/Presented At
Mehta, R. H., O'neill, W. W., Harjai, K. J., Cox, D. A., Brodie, B. R., Boura, J., Grines, L., Stone, G. W., Grines, C. L., & Primary Angioplasty in Myocardial Infarction (PAMI) and the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Investigators (2006). Prediction of one-year mortality among 30-day survivors after primary percutaneous coronary interventions. The American journal of cardiology, 97(6), 817–822. https://doi.org/10.1016/j.amjcard.2005.09.131
Disciplines
Medicine and Health Sciences
PubMedID
16516582
Department(s)
Department of Medicine
Document Type
Article