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  • Title: Predictors of in-hospital prognosis after primary percutaneous coronary intervention for acute myocardial infarction requiring mechanical support devices.
    Author: Shiraishi J, Kohno Y, Sawada T, Kimura M, Ariyoshi M, Matsui A, Takeda M, Arihara M, Hyogo M, Shima T, Okada T, Nakamura T, Matoba S, Yamada H, Matsumuro A, Kitamura M, Furukawa K, Matsubara H, AMI-Kyoto Multi-Center Risk Study Group.
    Journal: Circ J; 2010 Jun; 74(6):1152-7. PubMed ID: 20379002.
    Abstract:
    BACKGROUND: Predictors of in-hospital outcome after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) requiring mechanical support devices such as intra-aortic balloon pumping (IABP) and/or percutaneous cardiopulmonary support (PCPS) 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 requiring mechanical assist devices (with-IABP/PCPS patients, n=275) and those without (without-IABP/PCPS patients, n=1,510). The with-IABP/PCPS patients were more likely to have a larger number of diseased vessels, lower Thrombolysis In Myocardial Infarction (TIMI) grade in the infarct-related artery (IRA) before/after primary PCI, and a significantly higher in-hospital mortality rate than the without-IABP/PCPS patients. On multivariate analysis, the number of diseased vessels > or =2 or diseased left main trunk (LMT) at initial coronary angiography (CAG) was the independent positive predictor of the in-hospital mortality in the with-IABP/PCPS patients, not in the without-IABP/PCPS patients, whereas acquisition of TIMI 3 flow in the IRA immediately after primary PCI was the negative predictor in the without-IABP/PCPS patients, not in the with-IABP/PCPS patients. CONCLUSIONS: The number of diseased vessels > or =2 or diseased LMT at initial CAG is an independent risk factor of in-hospital death in primary PCI-treated AMI patients requiring mechanical support devices.
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