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Optimal Timing of Percutaneous Coronary Intervention in Patients With Non–ST-Segment Elevation Myocardial Infarction Complicated by Acute Decompensated Heart Failure (from the Korea Acute Myocardial Infarction Registry-National Institutes of Health [KAMIR-NIH])
- Source :
- The American Journal of Cardiology. 121:1285-1292
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- The optimal timing of percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI), complicated by acute decompensated heart failure (ADHF), is unclear. A total of 1,027 patients with NSTEMI complicated by ADHF who underwent successful PCI were analyzed using a Korean multicenter registry. All patients were divided into 4 groups by the timing of PCI: group 1 (PCI 2 hour after admission, n = 149), group 2 (2 to 24 hours, n = 577), group 3 (24 to 72 hours, n = 189), and group 4 (≥72 hours, n = 112). We analyzed the incidences of 12-month mortality, nonfatal myocardial infarction (MI), target-vessel revascularization, and rehospitalization because of HF. The prevalence of ADHF in patients with NSTEMI was 15.2% at initial presentation, and in-hospital mortality was higher in group 1 than in the other groups. There were no significant differences in mortality, nonfatal MI, target-vessel revascularization, or rehospitalization for HF during the 12-month follow-up between groups, regardless of initial PCI timing, except for a higher 12-month mortality in patients who received PCI within 24 hours (vs ≥24 hours) (hazard ratio 1.52, 95% confidence interval 1.09 to 2.29, p = 0.046). Early PCI did not reduce adverse clinical outcomes in patients with NSTEMI complicated by ADHF. Delayed PCI after stabilization may be reasonable in such high-risk patients.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Acute decompensated heart failure
medicine.medical_treatment
Myocardial Infarction
Hospital mortality
030204 cardiovascular system & hematology
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Internal medicine
Republic of Korea
Myocardial Revascularization
medicine
Humans
ST segment
In patient
Hospital Mortality
Registries
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Mortality
Non-ST Elevated Myocardial Infarction
Aged
Proportional Hazards Models
Aged, 80 and over
Heart Failure
business.industry
Proportional hazards model
Percutaneous coronary intervention
Middle Aged
medicine.disease
Hospitalization
surgical procedures, operative
Conventional PCI
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
therapeutics
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 121
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....5dc8ece57aa76f6785f36247c2b9babd