Naslov
Acute occlusion of the infarct-related artery as a predictor of very long-term mortality in patients with acute myocardial infarction

Autori
Kos, Nikola ; Zeljković, Ivan ; Krčmar, Tomislav ; Golubić, Karlo ; Šaler, Fran ; Erceg, Marijan ; Delić-Brkljačić, Diana ; Bulj, Nikola

Izvornik
Cardiology research and practice (2090-8016) 2021 (2021); 6647626, 6

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
percutaneous coronary intervention ; ST elevation myocardial infarction ; non-ST elevated myocardial infarction ; acute coronary syndrome ; follow-up studies ; myocardial infarction ; electrocardiography

Sažetak
Aim: The survey's aim was to examine the significance of infarct- related artery (IRA) occlusion (verified angiographically) on very long-term outcomes of patients with acute myocardial infarction, within the STEMI and NSTEMI diagnosis. Methods: A single- center, nonrandomized, registry- based study on patients treated for acute coronary syndrome with percutaneous coronary intervention between June 2011 and December 2016 was conducted. Patients with angiographically proven IRA occlusion (100% stenosis with TIMI flow 0 distal to occlusion) were categorized as occlusive myocardial infarction (OMI) and patients with patent IRA (50-99% stenosis with TIMI 1-3 flow) were categorized as nonocclusive myocardial infarction (NOMI) and very long-term outcomes were analyzed. Data were collected prospectively from the hospital's PCI registry and the database of the Croatian Institute of Public Health. Results: A total of 2450 patients were included in the study. 796 (32.5%) patients had NOMI and 1654 patients (67.5%) had OMI. According to ECG changes, 1534 patients presented with STEMI (62, 6%) and 916 with NSTEMI (37, 8%). 88% of STEMI patients presented with OMI and 12% with NOMI, while patients with NSTEMI in 33, 8% presented with OMI and in 66, 81% with NOMI. A median follow-up was 4.7 years. There was no significant difference in cardiovascular mortality between the groups (14.8% vs 13.1% ; OMI vs NOMI, respectively ; p=0.374) neither in all-cause mortality (19% vs 21.5% ; OMI vs NOMI, respectively ; p=0.374). Patients with NSTEMI had a significantly higher very long-term mortality (21.6% vs 18.1% ; NSTEMI vs STEMI, respectively ; p=0.029). Conclusion: The main findings of the study are as follows: (1) total IRA occlusion was not associated with higher long-term mortality ; (2) NSTEMI was associated with a higher mortality rate compared with STEMI, independent of angiographic presentation (OMI/NOMI) ; (3) IRA occlusion was not associated with significantly higher mortality rates in patients with STEMI and NSTEMI, respectively.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA