In patients with recurrent acute myocardial infarction undergoing primary percutaneous coronary intervention, having ≥2 diseased vessels or a diseased left main trunk was an independent predictor of in-hospital mortality (OR 2.673).
Observational (n=1,785)
Yes
Does primary percutaneous coronary intervention (PCI) for recurrent myocardial infarction have different predictors of in-hospital mortality compared to primary PCI for first myocardial infarction?
In patients undergoing primary PCI for recurrent AMI, multivessel or left main disease is an independent predictor of in-hospital mortality, suggesting that infarct-related artery-only PCI may be insufficient for this high-risk group.
Odds Ratio: 2.673 (95% CI 1.029–6.944)
p-value: p=0.0435
BACKGROUND: Recurrent acute myocardial infarction (AMI) is a deteriorated condition with high in-hospital morbidity and mortality, but the predictors of in-hospital outcome after primary percutaneous coronary intervention (PCI) for repeat AMI remain unclear. METHODS AND RESULTS: Using the AMI-Kyoto Multi-Center Risk Study database, clinical background, angiographic findings, results of primary PCI, and in-hospital prognosis were retrospectively compared between primary PCI-treated AMI patients with previous myocardial infarction (MI) (repeat-MI patients, n=235) and those without previous MI (first-MI patients, n=1,550). The repeat-MI patients had higher prevalence of Killip class>or=3 at admission, larger number of diseased vessels, and a significantly higher in-hospital mortality rate than the first-MI patients. On multivariate analysis, number of diseased vessels>or=2 or diseased left main trunk (LMT) on initial coronary angiography was the independent positive predictor of in-hospital mortality in the repeat-MI patients, not in the first-MI patients, whereas acquisition of Thrombolysis In Myocardial Infarction 3 flow in the infarct-related artery immediately after primary PCI and elapsed timeor=2 or diseased LMT on initial coronary angiography is an independent risk factor of in-hospital death in recurrent-AMI patients undergoing primary PCI.
Shiraishi et al. (Tue,) conducted a observational in Acute myocardial infarction undergoing primary percutaneous coronary intervention (n=1,785). Number of diseased vessels ≥2 or diseased left main trunk (LMT) vs. <2 diseased vessels was evaluated on In-hospital mortality in recurrent AMI patients (OR 2.673, 95% CI 1.029-6.944, p=0.0435). In patients with recurrent acute myocardial infarction undergoing primary percutaneous coronary intervention, having ≥2 diseased vessels or a diseased left main trunk was an independent predictor of in-hospital mortality (OR 2.673).