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AS-136 Clinical and Angiographic Procedural Predictors of Myocardial Blush Grade 3 After Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction
Wednesday, April 27 - Friday April 29, 2011 (Poster Abstract Zone) contrast injection and CT scan were not associated with IS. At 2 months, clinical outcome was similar between the groups. Still, group I maintained reduced IS (13.1⫾8.5 ml vs. 20.9⫾10.5 ml, p⫽0.072) and improved LVEF (63.1⫾6.5% vs. 53.6⫾14.8%, p⫽0.042). Conclusion: MT during primary PCI for acute STEMI was effective in limiting infarct expansion and improving LV function.
AS-135 Incidence of Tachyarrhythmia and its Impact on Two-Year Clinical Outcomes in Patients with ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents. Ji Young Park1, Seung-Woon Rha2, Kanhaiya L. Poddar2, Meera Kumari2, Byoung Geol Choi2, Yun Kyung Kim2, Jin Oh Na2, Cheol Ung Choi2, Hong Euy Lim2, Jin Won Kim2, Eung Ju Kim2, Chang Gyu Park2, Hong Seog Seo2, Dong Joo Oh2. 2Korean University Guro Hospital, Seoul, Korea (Republic of); 1Eulji General Hospital, Seoul, Korea (Republic of).
P O S T E R
Background: Tachyarrhythmias such as serious atrial and ventricular arrhythmias could occur during percutaneous coronary interventions (PCI) in patients (pts) with ST elevation myocardial infarction (STEMI). However, there were limited data regarding the incidence of tachyarrhythmias and its impact on the long term clinical outcomes in STEMI pts undergoing PCI with drug-eluting stents (DESs). Methods: This study consisted of 2224 consecutive pts underwent PCI from November 2005 to June 2008. Among them, 434 consecutive STEMI pts underwent PCI with DESs were enrolled for the analysis. The angiographic and major clinical outcomes of pts with tachyarrhythmia (n⫽ 32pts, 7.4%) were compared with those of Control group (n⫽ 402 pts, 92.6%) up to 2 years. Results: The STEMI group showed higher incidence of sustained ventricular tachycardia (VT), non-sustained VT, ventricular fibrillation (VF) and atrial fibrillation (AF) compared with those of other two groups (Table 1). The baseline clinical and procedural characteristics were similar between pts with tachyarrhythmia and those of control group. Six-month angiographic and cumulative clinical outcomes up to 2 years were similar between the two groups except pts with tachyarrhythmia showed higher incidence of cardiac death within 1 month compared with control group but not at 6 to 24 months (Table 2). Tachyarrhythmia itself was not an independent predictor of cardiac death (Adjusted OR: 1.711, 95% CI: 0.443-6.616, p-value⫽0.436) within 1 month.
A B S T R A C T S
cardiac death within 1 month. However, development of tachyarrhythmia was not an adverse indicator for worse clinical outcomes in STEMI pts undergoing PCI with DESs.
AS-136 Clinical and Angiographic Procedural Predictors of Myocardial Blush Grade 3 After Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction. Jae Woong Choi, Ji Young Park, Sung Kee Ryu. Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea (Republic of). Background: Myocardial brush grade (MBG) is used to assess the effectiveness of myocardial reperfusion and impaired MBG is known to be an independent predictor of long term mortality. Early risk stratification to obtain MBG 3 after primary percutaneous coronary intervention (PCI) may benefit in patients with acute myocardial infarction (AMI). The aim of this study is to evaluate the clinical and angiographic procedural predictors which had impact on the MBG 3 in patients with primary PCI. Methods: A total of 175 consecutive patients (pts) undergoing PCI for AMI were enrolled from May 2004 to June 2010 (116 males, mean age of 61.54 ⫾ 12.00 years). After PCI, patients were divided into two groups (MBG 3 group: n⫽111, non-MBG 3 group : n⫽64). Baseline clinical and angiographic characteristics were compared between two groups, and clinical and angiographic procedural predictors of post-procedure MBG 3 were evaluated. Results: Baseline clinical and angiographic characteristics showed that incidence of diabetes mellitus (DM, 33.9% vs 66.1%, p⫽0.024), hypertension (HTN, 57.6% vs 69.4%, p⫽0.05), smoking (36.6% vs 63.4%, p⫽0.031) and systolic blood pressure (SBP, 120.62 ⫾ 27.36 132.76 ⫾ 28.32, P⫽0.039) were higher in non-MBG 3 group. Left ventricular ejection fraction (LVEF, 52.54 ⫾ 10.88 vs 44.40 ⫾ 11.39, p⫽0.001), the rate of RCA ( 44.9% vs 30.7%, p⫽0.023) and post TIMI 3 flow (96.5% vs 71.2%, p⫽0.001) were higher in MBG 3 group. Lesion length (17.74⫾6.96 vs 21.57⫾17.80, p⫽0.02), balloon length (16.50⫾3.87 vs 18.18 ⫾3.76, p⫽0.02) and stent length (18.59 ⫾ 5.35vs 20.07⫾5.79) were longer in non-MBG3 group. The rate of total occlusion (38.6% vs 60.5%, p⫽0.001), thrombus (57.6% vs 72.8%, p⫽0.023), pre-TIMI 0or 1 flow (66.9% vs 84%, p⫽0.001) were higher in non-MBG 3 group. Multivariate analysis showed that low LVEF (HR ⫽ 7.286, p-value ⬍0.001, 95% CI: 2.599-20.423) and total occlusion (HR ⫽2.342, p-value⫽0.009, 95% CI: 1.239-4.426) were independent predictor of non-MBG 3. Conclusion: Lower LVEF and total occlusion were independent predictor of non-MBG 3. As the result, we assumed that the AMI patients with high risk clinical and angiographic characteristics may have lower chance of MBG3 and could consider adjunctive therapy such as aspiration thrombectomy.
AS-137
Conclusion: In our study, the incidence of tachyarrhythmia was higher in STEMI pts and was associated with higher incidence of
38A
Transradial versus Transfemoral Intervention in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention with Drug-eluting Stents. Seung-Woon Rha1, Ji Young Park1, Cheol Ung Choi1, Dong Joo Oh1, Byung Ryul Cho2, Moo Hyun Kim3, Doo-Il Kim4, Myung-Ho Jeong5, Sang Yong Yoo6, Sang-Sik Jeong6, Byung Ok Kim7, Min Su Hyun8, Junghan Yoon9. 1Cardiovascular Center Korea University Guro Hospital, Seoul, Korea (Republic of); 2 Kangwon National University Hospital, Chuncheon, Korea (Republic of); 3Dong-A University Medical Center, Busan, Korea (Republic of); 4Inje University Pusan Paik Hospital, Busan, Korea (Republic of); 5Chonnam National University Hospital, Gwangju, Korea (Republic of); 6Ulsan University GangNeung Asan Hospital, GangNeung, Korea (Republic of); 7University Sang-gye Paik Hospital, Seoul, Korea (Republic of); 8SoonChunHyang University Hospital, Cheonan, Korea (Republic of); 9Yonsei University Wonju Hospital, Wonju, Korea (Republic of).
The American Journal of Cardiology姞 APRIL 27–29, 2011 ANGIOPLASTY SUMMIT ABSTRACTS/Poster
AS-135 Incidence of Tachyarrhythmia and its Impact on Two-Year Clinical Outcomes in Patients with ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents. Ji Young Park1, Seung-Woon Rha2, Kanhaiya L. Poddar2, Meera Kumari2, Byoung Geol Choi2, Yun Kyung Kim2, Jin Oh Na2, Cheol Ung Choi2, Hong Euy Lim2, Jin Won Kim2, Eung Ju Kim2, Chang Gyu Park2, Hong Seog Seo2, Dong Joo Oh2. 2Korean University Guro Hospital, Seoul, Korea (Republic of); 1Eulji General Hospital, Seoul, Korea (Republic of).
P O S T E R
Background: Tachyarrhythmias such as serious atrial and ventricular arrhythmias could occur during percutaneous coronary interventions (PCI) in patients (pts) with ST elevation myocardial infarction (STEMI). However, there were limited data regarding the incidence of tachyarrhythmias and its impact on the long term clinical outcomes in STEMI pts undergoing PCI with drug-eluting stents (DESs). Methods: This study consisted of 2224 consecutive pts underwent PCI from November 2005 to June 2008. Among them, 434 consecutive STEMI pts underwent PCI with DESs were enrolled for the analysis. The angiographic and major clinical outcomes of pts with tachyarrhythmia (n⫽ 32pts, 7.4%) were compared with those of Control group (n⫽ 402 pts, 92.6%) up to 2 years. Results: The STEMI group showed higher incidence of sustained ventricular tachycardia (VT), non-sustained VT, ventricular fibrillation (VF) and atrial fibrillation (AF) compared with those of other two groups (Table 1). The baseline clinical and procedural characteristics were similar between pts with tachyarrhythmia and those of control group. Six-month angiographic and cumulative clinical outcomes up to 2 years were similar between the two groups except pts with tachyarrhythmia showed higher incidence of cardiac death within 1 month compared with control group but not at 6 to 24 months (Table 2). Tachyarrhythmia itself was not an independent predictor of cardiac death (Adjusted OR: 1.711, 95% CI: 0.443-6.616, p-value⫽0.436) within 1 month.
A B S T R A C T S
cardiac death within 1 month. However, development of tachyarrhythmia was not an adverse indicator for worse clinical outcomes in STEMI pts undergoing PCI with DESs.
AS-136 Clinical and Angiographic Procedural Predictors of Myocardial Blush Grade 3 After Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction. Jae Woong Choi, Ji Young Park, Sung Kee Ryu. Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea (Republic of). Background: Myocardial brush grade (MBG) is used to assess the effectiveness of myocardial reperfusion and impaired MBG is known to be an independent predictor of long term mortality. Early risk stratification to obtain MBG 3 after primary percutaneous coronary intervention (PCI) may benefit in patients with acute myocardial infarction (AMI). The aim of this study is to evaluate the clinical and angiographic procedural predictors which had impact on the MBG 3 in patients with primary PCI. Methods: A total of 175 consecutive patients (pts) undergoing PCI for AMI were enrolled from May 2004 to June 2010 (116 males, mean age of 61.54 ⫾ 12.00 years). After PCI, patients were divided into two groups (MBG 3 group: n⫽111, non-MBG 3 group : n⫽64). Baseline clinical and angiographic characteristics were compared between two groups, and clinical and angiographic procedural predictors of post-procedure MBG 3 were evaluated. Results: Baseline clinical and angiographic characteristics showed that incidence of diabetes mellitus (DM, 33.9% vs 66.1%, p⫽0.024), hypertension (HTN, 57.6% vs 69.4%, p⫽0.05), smoking (36.6% vs 63.4%, p⫽0.031) and systolic blood pressure (SBP, 120.62 ⫾ 27.36 132.76 ⫾ 28.32, P⫽0.039) were higher in non-MBG 3 group. Left ventricular ejection fraction (LVEF, 52.54 ⫾ 10.88 vs 44.40 ⫾ 11.39, p⫽0.001), the rate of RCA ( 44.9% vs 30.7%, p⫽0.023) and post TIMI 3 flow (96.5% vs 71.2%, p⫽0.001) were higher in MBG 3 group. Lesion length (17.74⫾6.96 vs 21.57⫾17.80, p⫽0.02), balloon length (16.50⫾3.87 vs 18.18 ⫾3.76, p⫽0.02) and stent length (18.59 ⫾ 5.35vs 20.07⫾5.79) were longer in non-MBG3 group. The rate of total occlusion (38.6% vs 60.5%, p⫽0.001), thrombus (57.6% vs 72.8%, p⫽0.023), pre-TIMI 0or 1 flow (66.9% vs 84%, p⫽0.001) were higher in non-MBG 3 group. Multivariate analysis showed that low LVEF (HR ⫽ 7.286, p-value ⬍0.001, 95% CI: 2.599-20.423) and total occlusion (HR ⫽2.342, p-value⫽0.009, 95% CI: 1.239-4.426) were independent predictor of non-MBG 3. Conclusion: Lower LVEF and total occlusion were independent predictor of non-MBG 3. As the result, we assumed that the AMI patients with high risk clinical and angiographic characteristics may have lower chance of MBG3 and could consider adjunctive therapy such as aspiration thrombectomy.
AS-137
Conclusion: In our study, the incidence of tachyarrhythmia was higher in STEMI pts and was associated with higher incidence of
38A
Transradial versus Transfemoral Intervention in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention with Drug-eluting Stents. Seung-Woon Rha1, Ji Young Park1, Cheol Ung Choi1, Dong Joo Oh1, Byung Ryul Cho2, Moo Hyun Kim3, Doo-Il Kim4, Myung-Ho Jeong5, Sang Yong Yoo6, Sang-Sik Jeong6, Byung Ok Kim7, Min Su Hyun8, Junghan Yoon9. 1Cardiovascular Center Korea University Guro Hospital, Seoul, Korea (Republic of); 2 Kangwon National University Hospital, Chuncheon, Korea (Republic of); 3Dong-A University Medical Center, Busan, Korea (Republic of); 4Inje University Pusan Paik Hospital, Busan, Korea (Republic of); 5Chonnam National University Hospital, Gwangju, Korea (Republic of); 6Ulsan University GangNeung Asan Hospital, GangNeung, Korea (Republic of); 7University Sang-gye Paik Hospital, Seoul, Korea (Republic of); 8SoonChunHyang University Hospital, Cheonan, Korea (Republic of); 9Yonsei University Wonju Hospital, Wonju, Korea (Republic of).
The American Journal of Cardiology姞 APRIL 27–29, 2011 ANGIOPLASTY SUMMIT ABSTRACTS/Poster