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Interaction of Chronic Total Occlusion and Chronic Kidney Disease in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction

Chronic total occlusion (CTO) in a non-infarct-related artery and chronic kidney failure (CKD) are associated with worse outcomes after primary percutaneous coronary intervention (PCI). The aim of this study was to investigate the interaction of CTO and CKD in patients who underwent primary PCI for... Full description

Journal Title: The American journal of cardiology 2013, Vol.112 (2), p.194-199
Main Author: Bataille, Yoann, MD
Other Authors: Plourde, Guillaume, MS , Machaalany, Jimmy, MD , Abdelaal, Eltigani, MD , Déry, Jean-Pierre, MD , Larose, Éric, DVM, MD , Déry, Ugo, PhD , Noël, Bernard, MD , Barbeau, Gérald, MD , Roy, Louis, MD , Costerousse, Olivier, PhD , Bertrand, Olivier F., MD, PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Abridged Index Medicus
Aged
Cardiology
Cardiovascular
Cardiovascular disease
Chronic Disease
Coronary Occlusion - complications
Coronary Occlusion - epidemiology
Coronary vessels
Female
Follow-Up Studies
Heart attacks
Humans
Male
Middle Aged
Mortality
Myocardial Infarction - complications
Myocardial Infarction - mortality
Myocardial Infarction - surgery
Percutaneous Coronary Intervention
Prevalence
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - mortality
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9149
Link: https://www.ncbi.nlm.nih.gov/pubmed/23601580
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title: Interaction of Chronic Total Occlusion and Chronic Kidney Disease in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction
format: Article
creator:
  • Bataille, Yoann, MD
  • Plourde, Guillaume, MS
  • Machaalany, Jimmy, MD
  • Abdelaal, Eltigani, MD
  • Déry, Jean-Pierre, MD
  • Larose, Éric, DVM, MD
  • Déry, Ugo, PhD
  • Noël, Bernard, MD
  • Barbeau, Gérald, MD
  • Roy, Louis, MD
  • Costerousse, Olivier, PhD
  • Bertrand, Olivier F., MD, PhD
subjects:
  • Abridged Index Medicus
  • Aged
  • Cardiology
  • Cardiovascular
  • Cardiovascular disease
  • Chronic Disease
  • Coronary Occlusion - complications
  • Coronary Occlusion - epidemiology
  • Coronary vessels
  • Female
  • Follow-Up Studies
  • Heart attacks
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • Myocardial Infarction - complications
  • Myocardial Infarction - mortality
  • Myocardial Infarction - surgery
  • Percutaneous Coronary Intervention
  • Prevalence
  • Renal Insufficiency, Chronic - complications
  • Renal Insufficiency, Chronic - mortality
ispartof: The American journal of cardiology, 2013, Vol.112 (2), p.194-199
description: Chronic total occlusion (CTO) in a non-infarct-related artery and chronic kidney failure (CKD) are associated with worse outcomes after primary percutaneous coronary intervention (PCI). The aim of this study was to investigate the interaction of CTO and CKD in patients who underwent primary PCI for acute ST-segment elevation myocardial infarction (STEMI). Patients with STEMIs with or without CKD, defined as an estimated glomerular filtration rate 75 years (HR 1.86, 95% CI 1.19 to 2.95), a left ventricular ejection fraction after primary PCI
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleInteraction of Chronic Total Occlusion and Chronic Kidney Disease in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction
creatorBataille, Yoann, MD ; Plourde, Guillaume, MS ; Machaalany, Jimmy, MD ; Abdelaal, Eltigani, MD ; Déry, Jean-Pierre, MD ; Larose, Éric, DVM, MD ; Déry, Ugo, PhD ; Noël, Bernard, MD ; Barbeau, Gérald, MD ; Roy, Louis, MD ; Costerousse, Olivier, PhD ; Bertrand, Olivier F., MD, PhD
creatorcontribBataille, Yoann, MD ; Plourde, Guillaume, MS ; Machaalany, Jimmy, MD ; Abdelaal, Eltigani, MD ; Déry, Jean-Pierre, MD ; Larose, Éric, DVM, MD ; Déry, Ugo, PhD ; Noël, Bernard, MD ; Barbeau, Gérald, MD ; Roy, Louis, MD ; Costerousse, Olivier, PhD ; Bertrand, Olivier F., MD, PhD
descriptionChronic total occlusion (CTO) in a non-infarct-related artery and chronic kidney failure (CKD) are associated with worse outcomes after primary percutaneous coronary intervention (PCI). The aim of this study was to investigate the interaction of CTO and CKD in patients who underwent primary PCI for acute ST-segment elevation myocardial infarction (STEMI). Patients with STEMIs with or without CKD, defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2 , were categorized into those with single-vessel disease and those with multivessel disease with or without CTO. The primary outcomes were the incidence of 30-day and 1-year mortality. Among 1,873 consecutive patients with STEMIs included between 2006 and 2011, 336 (18%) had CKD. The prevalence of CTO in a non-infarct-related artery was 13% in patients with CKD compared with 7% in those without CKD (p = 0.0003). There was a significant interaction between CKD and CTO on 30-day mortality (p = 0.018) and 1-year mortality (p = 0.013). Independent predictors of late mortality in patients with CKD were previous myocardial infarction (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.01 to 2.79), age >75 years (HR 1.86, 95% CI 1.19 to 2.95), a left ventricular ejection fraction after primary PCI <40% (HR 2.20, 95% CI 1.36 to 3.63), left main culprit artery (HR 4.46, 95% CI 1.64 to 10.25), and shock (HR 7.44, 95% CI 4.56 to 12.31), but multivessel disease with CTO was not a predictor. In contrast, multivessel disease with CTO was an independent predictor of mortality in patients without CKD (HR 3.30, 95% CI 1.70 to 6.17). In conclusion, in patients with STEMIs who underwent primary PCI, with preexisting CKD, the prevalence of CTO in a non-infarct-related artery was twice as great. In these patients, the clinical impact of CTO seems to be overshadowed by the presence of CKD.
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publisherUnited States: Elsevier Inc
subjectAbridged Index Medicus ; Aged ; Cardiology ; Cardiovascular ; Cardiovascular disease ; Chronic Disease ; Coronary Occlusion - complications ; Coronary Occlusion - epidemiology ; Coronary vessels ; Female ; Follow-Up Studies ; Heart attacks ; Humans ; Male ; Middle Aged ; Mortality ; Myocardial Infarction - complications ; Myocardial Infarction - mortality ; Myocardial Infarction - surgery ; Percutaneous Coronary Intervention ; Prevalence ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - mortality
ispartofThe American journal of cardiology, 2013, Vol.112 (2), p.194-199
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0Bataille, Yoann, MD
1Plourde, Guillaume, MS
2Machaalany, Jimmy, MD
3Abdelaal, Eltigani, MD
4Déry, Jean-Pierre, MD
5Larose, Éric, DVM, MD
6Déry, Ugo, PhD
7Noël, Bernard, MD
8Barbeau, Gérald, MD
9Roy, Louis, MD
10Costerousse, Olivier, PhD
11Bertrand, Olivier F., MD, PhD
title
0Interaction of Chronic Total Occlusion and Chronic Kidney Disease in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction
1The American journal of cardiology
addtitleAm J Cardiol
descriptionChronic total occlusion (CTO) in a non-infarct-related artery and chronic kidney failure (CKD) are associated with worse outcomes after primary percutaneous coronary intervention (PCI). The aim of this study was to investigate the interaction of CTO and CKD in patients who underwent primary PCI for acute ST-segment elevation myocardial infarction (STEMI). Patients with STEMIs with or without CKD, defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2 , were categorized into those with single-vessel disease and those with multivessel disease with or without CTO. The primary outcomes were the incidence of 30-day and 1-year mortality. Among 1,873 consecutive patients with STEMIs included between 2006 and 2011, 336 (18%) had CKD. The prevalence of CTO in a non-infarct-related artery was 13% in patients with CKD compared with 7% in those without CKD (p = 0.0003). There was a significant interaction between CKD and CTO on 30-day mortality (p = 0.018) and 1-year mortality (p = 0.013). Independent predictors of late mortality in patients with CKD were previous myocardial infarction (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.01 to 2.79), age >75 years (HR 1.86, 95% CI 1.19 to 2.95), a left ventricular ejection fraction after primary PCI <40% (HR 2.20, 95% CI 1.36 to 3.63), left main culprit artery (HR 4.46, 95% CI 1.64 to 10.25), and shock (HR 7.44, 95% CI 4.56 to 12.31), but multivessel disease with CTO was not a predictor. In contrast, multivessel disease with CTO was an independent predictor of mortality in patients without CKD (HR 3.30, 95% CI 1.70 to 6.17). In conclusion, in patients with STEMIs who underwent primary PCI, with preexisting CKD, the prevalence of CTO in a non-infarct-related artery was twice as great. In these patients, the clinical impact of CTO seems to be overshadowed by the presence of CKD.
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9Female
10Follow-Up Studies
11Heart attacks
12Humans
13Male
14Middle Aged
15Mortality
16Myocardial Infarction - complications
17Myocardial Infarction - mortality
18Myocardial Infarction - surgery
19Percutaneous Coronary Intervention
20Prevalence
21Renal Insufficiency, Chronic - complications
22Renal Insufficiency, Chronic - mortality
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titleInteraction of Chronic Total Occlusion and Chronic Kidney Disease in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction
authorBataille, Yoann, MD ; Plourde, Guillaume, MS ; Machaalany, Jimmy, MD ; Abdelaal, Eltigani, MD ; Déry, Jean-Pierre, MD ; Larose, Éric, DVM, MD ; Déry, Ugo, PhD ; Noël, Bernard, MD ; Barbeau, Gérald, MD ; Roy, Louis, MD ; Costerousse, Olivier, PhD ; Bertrand, Olivier F., MD, PhD
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1Aged
2Cardiology
3Cardiovascular
4Cardiovascular disease
5Chronic Disease
6Coronary Occlusion - complications
7Coronary Occlusion - epidemiology
8Coronary vessels
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10Follow-Up Studies
11Heart attacks
12Humans
13Male
14Middle Aged
15Mortality
16Myocardial Infarction - complications
17Myocardial Infarction - mortality
18Myocardial Infarction - surgery
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20Prevalence
21Renal Insufficiency, Chronic - complications
22Renal Insufficiency, Chronic - mortality
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5Larose, Éric, DVM, MD
6Déry, Ugo, PhD
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date2013
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issn0002-9149
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abstractChronic total occlusion (CTO) in a non-infarct-related artery and chronic kidney failure (CKD) are associated with worse outcomes after primary percutaneous coronary intervention (PCI). The aim of this study was to investigate the interaction of CTO and CKD in patients who underwent primary PCI for acute ST-segment elevation myocardial infarction (STEMI). Patients with STEMIs with or without CKD, defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2 , were categorized into those with single-vessel disease and those with multivessel disease with or without CTO. The primary outcomes were the incidence of 30-day and 1-year mortality. Among 1,873 consecutive patients with STEMIs included between 2006 and 2011, 336 (18%) had CKD. The prevalence of CTO in a non-infarct-related artery was 13% in patients with CKD compared with 7% in those without CKD (p = 0.0003). There was a significant interaction between CKD and CTO on 30-day mortality (p = 0.018) and 1-year mortality (p = 0.013). Independent predictors of late mortality in patients with CKD were previous myocardial infarction (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.01 to 2.79), age >75 years (HR 1.86, 95% CI 1.19 to 2.95), a left ventricular ejection fraction after primary PCI <40% (HR 2.20, 95% CI 1.36 to 3.63), left main culprit artery (HR 4.46, 95% CI 1.64 to 10.25), and shock (HR 7.44, 95% CI 4.56 to 12.31), but multivessel disease with CTO was not a predictor. In contrast, multivessel disease with CTO was an independent predictor of mortality in patients without CKD (HR 3.30, 95% CI 1.70 to 6.17). In conclusion, in patients with STEMIs who underwent primary PCI, with preexisting CKD, the prevalence of CTO in a non-infarct-related artery was twice as great. In these patients, the clinical impact of CTO seems to be overshadowed by the presence of CKD.
copUnited States
pubElsevier Inc
pmid23601580
doi10.1016/j.amjcard.2013.03.010