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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
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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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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
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1Plourde, Guillaume, MS
2Machaalany, Jimmy, MD
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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
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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
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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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10Follow-Up Studies
11Heart attacks
12Humans
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14Middle Aged
15Mortality
16Myocardial Infarction - complications
17Myocardial Infarction - mortality
18Myocardial Infarction - surgery
19Percutaneous Coronary Intervention
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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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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.
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pmid23601580
doi10.1016/j.amjcard.2013.03.010