- Email: [email protected]
TCT-320: The 12-month Clinical Outcomes of Acute ST-Segment Elevation Myocardial Infarction versus Acute Non ST-Segment Elevation Myocardial Infarction in Patients with Previous Acute Myocardial Infarction
http://www.aievolution.com/tct0901/
TUESDAY, SEPTEMBER 22, 2009, 8:00AM - 10:00AM
and 2007. Mean clinical follow-up was 3.7 years (SD ± 1.4 years). STR was GH¿QHGDVWKHUHODWLYHGLIIHUHQFH LQ RIWKHVXPPHG67VHJPHQWGHYLDWLRQ between the pre-PCI and the immediately post-PCI 12-lead ECG. STR was FDWHJRUL]HGDVFRPSOHWH SDUWLDO RUDEVHQW Results: At the time of primary angioplasty, 974 patients (46%) were current VPRNHUV,PPHGLDWHFRPSOHWH675ZDVPRUHIUHTXHQWDPRQJVPRNHUVWKDQ DPRQJQRQVPRNHUV YV S ,QDGGLWLRQLPPHGLDWH675 ZDVKLJKHUDPRQJVPRNHUVFRPSDUHGWRQRQVPRNHUV YV S $WRQHWKUHHDQG¿YH\HDUIROORZXSVPRNHUVVKRZHGDVLJQL¿FDQWO\ ORZHU PRUWDOLW\ UDWH FRPSDUHG WR QRQVPRNHUV ODUJHO\ LQGHSHQGHQW RI WKH DPRXQWRI675 VHH7DEOH $IWHUPXOWLYDULDEOHPRGHOLQJVPRNLQJUHPDLQHG independently predictive for improved one-year survival (OR 0.66, CI 0.45 0.97; p = 0.035), while incomplete STR (<70%) was an independent predictor of inferior survival (OR 2.6, CI 1.5 - 4.5; p = 0.001).
0$&( ZHUH VLJQL¿FDQWO\ ORZHU LQ WKH 167(0, JURXS 5HFXUUHQW $0, tended to be lower in the STEMI group, largely due to the less incidence of recurrent NSTEMI in the STEMI group (Table). Previous MI was an independent predictor of MACE at 12 months in pts with NSTEMI (OR:1.613, 95% CI: 1.109-92.347, P=0.012). Table. Clinical Outcomes at 12-month(n, %)
Total Mortality Cardiac Death TLR TVR Non-TVR Re--MI STEMI NSTEMI CABG Total Mace
STEMI N=442 10(2.3) 7(1.6) 9(2.0) 9(2.0) 14(3.2) 6(1.4) 2(0.5) 4(0.9) 5(1.1) 43(9.7)
NSTEMI N=492 38(7.7) 27(5.5) 9(1.8) 10(2.0) 11(2.2) 16(3.3) 2(0.4) 14(2.8) 3(0.6) 75(15.2)
P VALUES <0.001 0.001 0.818 0.997 0.378 0.057 0.914 0.031 0.388 0.011
Conclusion: When pts with prior MI history presenting with NSTEMI, they showed not only worse baseline clinical and procedural characteristics, but also showed worse major clinical outcomes up to 12 months compared with those of pts presenting with STEMI. TCT-321
Conclusion: ,Q 67(0, SDWLHQWV XQGHUJRLQJ SULPDU\ DQJLRSODVW\ VPRNHUV VKRZHGEHWWHU675FRPSDUHGWRQRQVPRNHUV%RWKVPRNLQJDQGLPPHGLDWH STR were independent strong predictors of long-term survival. Our results UHDI¿UP WKH VPRNHU¶V SDUDGR[ DQG SURYLGH HYLGHQFH IRU WKH WKHRU\ WKDW VPRNLQJ67(0,SDWLHQWVDFKLHYHEHWWHULPPHGLDWHPLFURYDVFXODUÀRZDIWHU reperfusion therapy. TCT-320
P O S T E R A B S T R AC T S
The 12-month Clinical Outcomes of Acute ST-Segment Elevation Myocardial Infarction versus Acute Non ST-Segment Elevation Myocardial Infarction in Patients with Previous Acute Myocardial Infarction Lin Wang1, Seung Woon Rha1, Ji Young Park1, Kanhaiya L Poddar1, Byoung Geol Choi1, Ji Bak Kim1, Seoung Yong Shin1, Un Jung Choi1, Cheol Ung Choi Choi1, Hong Euy Lim1, Jin Won Kim1, Eung Ju Kim1, Chang Gyu Park1, Hong Seog Seo1, Dong Joo Oh1, Young Keun Ahn2, Myung Ho Jeong2, Other KAMIR Investigators 1 Korea University Guro Hospital, Seoul, Republic of Korea2ChonNam National University Hospital, Gwangju, Republic of Korea Background: There are very limited data whether there are differences in clinical outcomes when a patient (pt) with previous history of myocardial infarction (MI) is presenting with acute ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). Method: The current data came from the Korea Acute Myocardial Infarction Registry (KAMIR) study, which consisted of 934 consecutive recurrent acute MI (AMI) pts (442 STEMI and 492 NSTEMI pts) from November 2005 to April 2008. We compared the clinical outcomes between the 2 groups up to 12 months. Results: The baseline characteristics were largely unfavorable in NSTEMI group over STEMI group. Although the incidence of repeat percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) were similar between the groups, the mortality and major adverse cardiac events
120D
Smoking Status and Outcomes of Patients with Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention: The HORIZONS-AMI trial Kenji Goto1, Eugenia Nikolsky1, Alexandra J Lansky1, Martin Fahy1, Bernhard Witzenbichler2, Giulio Guagliumi3, Jan Z Peruga4, Ecaterina Cristea1, Ivana Jankovic1, Laura LaSalle1, Roxana Mehran1, Gregg W Stone1 1 Cardiovascular Research Foundation, New York, NY;2Charité Campus Benjamin Franklin, Berlin, Germany3Ospedali Riuniti di Bergamo, Bergamo, Italy4Silesian Center for Heart Disease, Lodz, Poland Background: &LJDUHWWH VPRNLQJ LV VWURQJO\ DVVRFLDWHG ZLWK HQGRWKHOLDO dysfunction and increased platelet aggregation. The relative prognostic impact RI VPRNLQJ LQ SDWLHQWV SUHVHQWLQJ ZLWK 67VHJPHQW HOHYDWLRQ P\RFDUGLDO infarction (STEMI) continues to be controversial. We therefore sought to HYDOXDWHWKHUHODWLRQVKLSEHWZHHQVPRNLQJVWDWXVDQGRXWFRPHVRISDWLHQWV with STEMI. Methods: In HORIZONS-AMI, 3602 patients were randomly assigned to receive unfractionated heparin (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) or bivalirudin alone. Endpoints included major bleeding, major adverse cardiovascular events (MACE = death, reinfarction, target vessel UHYDVFXODUL]DWLRQIRULVFKHPLDRUVWURNH FRPSRVLWHQHWDGYHUVHFOLQLFDOHYHQWV 1$&( PDMRUEOHHGLQJRU0$&( DQGVWHQWWKURPERVLV $5&GH¿QLWHRU probable) in patients who underwent stent implantation. Results: $PRQJ SDWLHQWV ZLWK NQRZQ VPRNLQJ VWDWXV RQ DGPLVVLRQ ZHUHFXUUHQWVPRNHUV6PRNHUVFRPSDUHGWRQRQVPRNHUVZHUH younger, more frequently males, had lower BMI, and lower prevalence of FRPRUELGLWLHV 6PRNLQJ ZDV DVVRFLDWHG ZLWK VKRUWHU WLPH IURP V\PSWRPV RQVHW WR ¿UVW EDOORRQ LQÀDWLRQ ORZHU LQFLGHQFH RI /$' LQIDUFW YHVVHO DQG PRUHIUHTXHQWDFKLHYHPHQWRI¿QDO7,0,ÀRZJUDGH2QH\HDURXWFRPHV DUHSUHVHQWHGLQWKH7DEOH%\PXOWLYDULDEOHDQDO\VLVVPRNLQJZDVLGHQWL¿HG DV DQ LQGHSHQGHQW SUHGLFWRU RI GH¿QLWHSUREDEOH VWHQW WKURPERVLV DW \HDU +5 > &,@ > @ 3 WKRXJK WKHUH ZDV QR ORQJHU VLJQL¿FDQWDVVRFLDWLRQLQLQGLYLGXDOFRPSRQHQWVRI1$&(
The American Journal of Cardiology® |
September 21-25, 2009
|
TCT Abstracts/POSTER
TUESDAY, SEPTEMBER 22, 2009, 8:00AM - 10:00AM
and 2007. Mean clinical follow-up was 3.7 years (SD ± 1.4 years). STR was GH¿QHGDVWKHUHODWLYHGLIIHUHQFH LQ RIWKHVXPPHG67VHJPHQWGHYLDWLRQ between the pre-PCI and the immediately post-PCI 12-lead ECG. STR was FDWHJRUL]HGDVFRPSOHWH SDUWLDO RUDEVHQW Results: At the time of primary angioplasty, 974 patients (46%) were current VPRNHUV,PPHGLDWHFRPSOHWH675ZDVPRUHIUHTXHQWDPRQJVPRNHUVWKDQ DPRQJQRQVPRNHUV YV S ,QDGGLWLRQLPPHGLDWH675 ZDVKLJKHUDPRQJVPRNHUVFRPSDUHGWRQRQVPRNHUV YV S $WRQHWKUHHDQG¿YH\HDUIROORZXSVPRNHUVVKRZHGDVLJQL¿FDQWO\ ORZHU PRUWDOLW\ UDWH FRPSDUHG WR QRQVPRNHUV ODUJHO\ LQGHSHQGHQW RI WKH DPRXQWRI675 VHH7DEOH $IWHUPXOWLYDULDEOHPRGHOLQJVPRNLQJUHPDLQHG independently predictive for improved one-year survival (OR 0.66, CI 0.45 0.97; p = 0.035), while incomplete STR (<70%) was an independent predictor of inferior survival (OR 2.6, CI 1.5 - 4.5; p = 0.001).
0$&( ZHUH VLJQL¿FDQWO\ ORZHU LQ WKH 167(0, JURXS 5HFXUUHQW $0, tended to be lower in the STEMI group, largely due to the less incidence of recurrent NSTEMI in the STEMI group (Table). Previous MI was an independent predictor of MACE at 12 months in pts with NSTEMI (OR:1.613, 95% CI: 1.109-92.347, P=0.012). Table. Clinical Outcomes at 12-month(n, %)
Total Mortality Cardiac Death TLR TVR Non-TVR Re--MI STEMI NSTEMI CABG Total Mace
STEMI N=442 10(2.3) 7(1.6) 9(2.0) 9(2.0) 14(3.2) 6(1.4) 2(0.5) 4(0.9) 5(1.1) 43(9.7)
NSTEMI N=492 38(7.7) 27(5.5) 9(1.8) 10(2.0) 11(2.2) 16(3.3) 2(0.4) 14(2.8) 3(0.6) 75(15.2)
P VALUES <0.001 0.001 0.818 0.997 0.378 0.057 0.914 0.031 0.388 0.011
Conclusion: When pts with prior MI history presenting with NSTEMI, they showed not only worse baseline clinical and procedural characteristics, but also showed worse major clinical outcomes up to 12 months compared with those of pts presenting with STEMI. TCT-321
Conclusion: ,Q 67(0, SDWLHQWV XQGHUJRLQJ SULPDU\ DQJLRSODVW\ VPRNHUV VKRZHGEHWWHU675FRPSDUHGWRQRQVPRNHUV%RWKVPRNLQJDQGLPPHGLDWH STR were independent strong predictors of long-term survival. Our results UHDI¿UP WKH VPRNHU¶V SDUDGR[ DQG SURYLGH HYLGHQFH IRU WKH WKHRU\ WKDW VPRNLQJ67(0,SDWLHQWVDFKLHYHEHWWHULPPHGLDWHPLFURYDVFXODUÀRZDIWHU reperfusion therapy. TCT-320
P O S T E R A B S T R AC T S
The 12-month Clinical Outcomes of Acute ST-Segment Elevation Myocardial Infarction versus Acute Non ST-Segment Elevation Myocardial Infarction in Patients with Previous Acute Myocardial Infarction Lin Wang1, Seung Woon Rha1, Ji Young Park1, Kanhaiya L Poddar1, Byoung Geol Choi1, Ji Bak Kim1, Seoung Yong Shin1, Un Jung Choi1, Cheol Ung Choi Choi1, Hong Euy Lim1, Jin Won Kim1, Eung Ju Kim1, Chang Gyu Park1, Hong Seog Seo1, Dong Joo Oh1, Young Keun Ahn2, Myung Ho Jeong2, Other KAMIR Investigators 1 Korea University Guro Hospital, Seoul, Republic of Korea2ChonNam National University Hospital, Gwangju, Republic of Korea Background: There are very limited data whether there are differences in clinical outcomes when a patient (pt) with previous history of myocardial infarction (MI) is presenting with acute ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). Method: The current data came from the Korea Acute Myocardial Infarction Registry (KAMIR) study, which consisted of 934 consecutive recurrent acute MI (AMI) pts (442 STEMI and 492 NSTEMI pts) from November 2005 to April 2008. We compared the clinical outcomes between the 2 groups up to 12 months. Results: The baseline characteristics were largely unfavorable in NSTEMI group over STEMI group. Although the incidence of repeat percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) were similar between the groups, the mortality and major adverse cardiac events
120D
Smoking Status and Outcomes of Patients with Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention: The HORIZONS-AMI trial Kenji Goto1, Eugenia Nikolsky1, Alexandra J Lansky1, Martin Fahy1, Bernhard Witzenbichler2, Giulio Guagliumi3, Jan Z Peruga4, Ecaterina Cristea1, Ivana Jankovic1, Laura LaSalle1, Roxana Mehran1, Gregg W Stone1 1 Cardiovascular Research Foundation, New York, NY;2Charité Campus Benjamin Franklin, Berlin, Germany3Ospedali Riuniti di Bergamo, Bergamo, Italy4Silesian Center for Heart Disease, Lodz, Poland Background: &LJDUHWWH VPRNLQJ LV VWURQJO\ DVVRFLDWHG ZLWK HQGRWKHOLDO dysfunction and increased platelet aggregation. The relative prognostic impact RI VPRNLQJ LQ SDWLHQWV SUHVHQWLQJ ZLWK 67VHJPHQW HOHYDWLRQ P\RFDUGLDO infarction (STEMI) continues to be controversial. We therefore sought to HYDOXDWHWKHUHODWLRQVKLSEHWZHHQVPRNLQJVWDWXVDQGRXWFRPHVRISDWLHQWV with STEMI. Methods: In HORIZONS-AMI, 3602 patients were randomly assigned to receive unfractionated heparin (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) or bivalirudin alone. Endpoints included major bleeding, major adverse cardiovascular events (MACE = death, reinfarction, target vessel UHYDVFXODUL]DWLRQIRULVFKHPLDRUVWURNH FRPSRVLWHQHWDGYHUVHFOLQLFDOHYHQWV 1$&( PDMRUEOHHGLQJRU0$&( DQGVWHQWWKURPERVLV $5&GH¿QLWHRU probable) in patients who underwent stent implantation. Results: $PRQJ SDWLHQWV ZLWK NQRZQ VPRNLQJ VWDWXV RQ DGPLVVLRQ ZHUHFXUUHQWVPRNHUV6PRNHUVFRPSDUHGWRQRQVPRNHUVZHUH younger, more frequently males, had lower BMI, and lower prevalence of FRPRUELGLWLHV 6PRNLQJ ZDV DVVRFLDWHG ZLWK VKRUWHU WLPH IURP V\PSWRPV RQVHW WR ¿UVW EDOORRQ LQÀDWLRQ ORZHU LQFLGHQFH RI /$' LQIDUFW YHVVHO DQG PRUHIUHTXHQWDFKLHYHPHQWRI¿QDO7,0,ÀRZJUDGH2QH\HDURXWFRPHV DUHSUHVHQWHGLQWKH7DEOH%\PXOWLYDULDEOHDQDO\VLVVPRNLQJZDVLGHQWL¿HG DV DQ LQGHSHQGHQW SUHGLFWRU RI GH¿QLWHSUREDEOH VWHQW WKURPERVLV DW \HDU +5 > &,@ > @ 3 WKRXJK WKHUH ZDV QR ORQJHU VLJQL¿FDQWDVVRFLDWLRQLQLQGLYLGXDOFRPSRQHQWVRI1$&(
The American Journal of Cardiology® |
September 21-25, 2009
|
TCT Abstracts/POSTER