CBS 2019
CBSMD教育中心
中 文

急性冠脉综合征

Abstract

Recommended Article

Linking Spontaneous Coronary Artery Dissection, Cervical Artery Dissection, and Fibromuscular Dysplasia: Heart, Brain, and Kidneys Clinical Efficacy and Safety of Alirocumab after Acute Coronary Syndrome According to Achieved Level of Low-Density Lipoprotein Cholesterol: A Propensity Score-Matched Analysis of the ODYSSEY OUTCOMES Trial The Potential Use of the Index of Microcirculatory Resistance to Guide Stratification of Patients for Adjunctive Therapy in Acute Myocardial Infarction Comparative Effectiveness of β-Blocker Use Beyond 3 Years After Myocardial Infarction and Long-Term Outcomes Among Elderly Patients Another Nail in the Coffin for Intra-Aortic Balloon Counterpulsion in Acute Myocardial Infarction With Cardiogenic Shock Myocardial Infarction Risk Stratification With a Single Measurement of High-Sensitivity Troponin I Healed Culprit Plaques in Patients With Acute Coronary Syndromes Intensive Care Utilization in Stable Patients With ST-Segment Elevation Myocardial Infarction Treated With Rapid Reperfusion

Original Research2018 Jun 8;14(3):e306-e313.

JOURNAL:EuroIntervention. Article Link

Prognostic impact of non-culprit chronic total occlusions in infarct-related cardiogenic shock: results of the randomised IABP-SHOCK II trial

Saad M, Fuernau G, Thiele H et al. Keywords: STEMI; cardiogenic shock ; death ; chronic coronary total occlusion; NSTEMI ; IABP

ABSTRACT


AIMS - The aim of the current study was to investigate the impact of a chronic total occlusion (CTO) in a non-infarct-related coronary artery (non-IRA) on one-year mortality and occurrence of cardiac arrhythmia in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI).

 

METHODS AND RESULTS - In a retrospective sub-analysis of the Intraaortic Balloon Pump in Cardiogenic Shock II trial (IABP-SHOCK II) and its accompanying registry, 201 (26%) of 761 patients had a CTO in a non-IR major coronary artery. Mortality was significantly higher in the CTO group at day of admission (19% vs. 11%; p=0.005), 30 days (53% vs. 41%, p=0.002), and 12 months (63% vs. 51%, p=0.002). In the adjusted multivariate Cox regression analysis, a CTO in a non-IRA was an independent predictor of mortality at 12 months (hazard ratio 1.30, 95% confidence interval [CI]: 1.02-1.67, p=0.03). At 30-day follow-up, ventricular arrhythmias requiring defibrillation occurred more frequently in patients with non-IRA CTO in the univariate analysis (33% vs. 21%, odds ratio 1.83, 95% CI: 1.28-2.62, p=0.002).

 

CONCLUSIONS - In patients with CS complicating AMI, the presence of CTO in a non-IRA is associated with a higher incidence of ventricular arrhythmias and is an independent predictor of mortality at 12-month follow-up.