Periprocedural Myocardial Infarction and Clinical Outcomes in Diffuse versus Focal Coronary Artery Disease.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhang Han, Munhoz Daniel, Heggermont Ward, Vermeersch Paul, Sinnaeve Peter, Ikeda Kazumasa, Mizukami Takuya, Matsumura Mitsuaki, Sonck Jeroen, Matsuo Hitoshi, Amano Tetsuya, Ando Hirohiko, Hada Masahiro, Ko Brian, Biscaglia Simone, Rivero Fernando, Engstrøm Thomas, Leone Antonio Maria, van Nunen Lokien X, Fearon William F, Christiansen Evald Høj, Fournier Stephane, Desta Liyew, Shinke Toshiro, Yong Andy, Adjedj Julien, Escaned Javier, Nakayama Masafumi, Eftekhari Ashkan, Keulards Danielle, Zimmermann Frederik M, Korngold Ethan, Campo Gianluca, Bouisset Frédéric, Wilgenof Adriaan, Berry Colin, Collison Damien, Johnson Thomas W, Perera Divaka, Jeremias Allen, Cohen David, Ali Ziad, Mintz Gary S, Kirtane Ajay J, McEntegart Margaret B, Popma Alexandra, Popma Jeff, Dressler Ovidiu, Sandoval Yader, De Bruyne Bernard, Johnson Nils, Collet Carlos
Аннотация
OBJECTIVES: To compare the incidence and prognostic impact of PMI after PCI for vessels with focal versus diffuse diseases defined by pullback pressure gradient (PPG).
METHODS: We analyzed 855 patients undergoing PCI in the PPG Global registry. Physiological patterns of treated vessels were classified as focal or diffuse using PPG. PMI in the original registry was defined according to the Fourth Universal Definition of Myocardial Infarction (UDMI). The primary outcome of the current analysis was 1-year target vessel failure (TVF), a composite of cardiac death, spontaneous target-vessel myocardial infarction, or ischemia-driven target-vessel revascularization.
RESULTS: Fourth UDMI PMI was higher in patients with diffuse compared with focal physiology in the treated vessel (9.8% vs 5.9%; p=0.048). Troponin elevation ≥70 × URL(8.5% vs 4.8%; p=0.041) and PMI with flow-limiting angiographic complications (2.0% vs 0.2%; p=0.015) occurred more frequently after PCI for vessels with diffuse disease, whereas PMI with ischemic electrocardiographic changes was infrequent and similar between groups (0.8% vs 0.7%; p=1.000). 17 TVF occurred within 1 year; only troponin elevation ≥35 × URL accompanied by angiographic complications was associated with 1-year TVF.
CONCLUSIONS: PMI occurred more frequently after PCI for vessels with diffuse than focal coronary physiology, particularly phenotypes with higher troponin elevation or angiographic complications. Associations with 1-year TVF were observed only for PMI phenotypes incorporating angiographic complications; however, findings should be interpreted cautiously because TVF events were sparse.