ǥ :
|
ȣ - 550588 45 |
Impact of Left anterior descending artery lesion versus Non-left anterior descending artery lesion on 1-year Clinical Outcomes in patients with acute myocardial infarction undergoing percutaneous coronary intervention |
순천향의대부속천안병원¹ , 고려대학교의대부속구로병원² |
박상호¹ , 나승운² ,조아라¹ ,이혁규¹ ,이세환¹ ,이승진¹ ,신원용¹ ,진동규¹ ,최병걸² ,나진오² ,최철웅²,임홍의² ,김진원² ,김응주² ,박창규² ,서홍석² ,오동주² |
Background: There are few studies comparing the clinical outcomes of left anterior descending artery lesion (LAD) and non-left anterior descending artery (Non-LAD) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs).
Methods: A total of 685 patients with AMI undergoing PCI with DESs between 2004 to 2010 were enrolled (non-LAD, n=300 versus LAD, n=385). 1-year clinical outcomes including major adverse cardiac event (MACE), myocardial infarction, target vessel revascularization (TVR), target lesion revascularization (TLR), TVR-MACE, TLR-MACE were compared between two groups.
Results: There were no significant differences between the two groups except LAD group had more male, more history of current smoking and diabetes, lower left ventricular ejection fraction (LVEF), longer stent length, higher number of implanted stents (table). In-hospital cardiac death was similar to two groups. At 12 clinical outcomes (follow-up rate:92.4%), acute myocardial infarction was higher in LAD group. However, when adjusted by gender, diabetes, current smoking, LVEF, and stent length, clinical outcomes were not significantly different in two groups (table).
Conclusions: The AMI of LAD artery doesn’t seem to be different in a adverse clinical outcomes up to 12 months, compared with non-LAD artery.
|
Baseline character |
Non-LAD (n=300) |
LAD (n=385) |
p-value |
p-value* |
Gender (Male) |
223 (74.3) |
262 (68.0) |
0.073 |
|
Diabetes |
69 (23) |
115 (29.8) |
0.044 |
|
Current Smoking |
128 (42.6) |
134 (34.8) |
0.036 |
|
LVEF |
48.38±9.666 |
43.57±11.65 |
< 0.001 |
|
STENT Length |
24.05±6.707 |
24.55±6.665 |
0.019 |
|
Number of Stent implantation |
1.333±0.661 |
1.729±0.935 |
< 0.001 |
|
In-hospital Cardiac Death |
14 (4.66) |
20 (5.19) |
0.752 |
|
12-month Clinical outcomes |
Non-LAD (n=285) |
LAD (n=348) |
p-value |
|
All MACE |
50 (17.5) |
70 (20.1) |
0.412 |
|
TLR MACE |
33 (11.5) |
55 (15.8) |
0.126 |
|
TVR MACE |
44 (15.4) |
65 (18.6) |
0.283 |
|
Total Death |
22 (7.71) |
29 (8.33) |
0.778 |
|
Cardiac Death |
18 (6.31) |
26 (7.47) |
0.570 |
|
Any MI |
3 (1.05) |
13 (3.73) |
0.032 |
0.111* |
TLR |
16 (5.61) |
32 (9.19) |
0.090 |
|
TVR |
23 (8.07) |
38 (10.9) |
0.227 |
|
* P value adjusted gender, diabetes, current smoking, LVEF, and stent length
|
|
|