Predictors and long-term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary intervention
Objectives: We aimed to identify the predictors of angiographically visible distal embolization (AVDE) during primary percutaneous coronary intervention (p-PCI) as well as to assess its impact on short- and long-term clinical outcomes in patients with acute ST-segment elevation myocardial infarctio...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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KARE Publishing
2013-09-01
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| Series: | Türk Kardiyoloji Derneği Arşivi |
| Subjects: | |
| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-48265 |
| _version_ | 1797914011961917440 |
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| author | Vecih Oduncu Ayhan Erkol Burak Turan Taylan Akgün Can Yücel Karabay İbrahim Halil Tanboga Selçuk Pala Cevat Kırma Ali Metin Esen |
| author_facet | Vecih Oduncu Ayhan Erkol Burak Turan Taylan Akgün Can Yücel Karabay İbrahim Halil Tanboga Selçuk Pala Cevat Kırma Ali Metin Esen |
| author_sort | Vecih Oduncu |
| collection | DOAJ |
| description | Objectives: We aimed to identify the predictors of angiographically visible distal embolization (AVDE) during primary percutaneous coronary intervention (p-PCI) as well as to assess its impact on short- and long-term clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI).
Study design: We retrospectively enrolled 2007 patients with STEMI who underwent p-PCI. We assessed the clinical and angiographic characteristics of patients in order to identify the predictors of AVDE and compared the outcomes of patients with and without AVDE during p-PCI.
Results: Distal embolization developed in 135 (6.7%) patients. Age (for each 10- year increase, Odds Ratio (OR) 1.34, 95% Confidence Interval (CI) 1.16-1.52, p<0.001), treatment of right coronary artery (OR 2.52, 95% CI 1.30-4.87, p=0.034), repeated balloon dilatation (OR 1.84, 95% CI 1.16- 2.94, p=0.009), cut-off occlusion pattern (OR 2.17, 95% CI 1.38-3.42, p=0.001), lesion length >15 mm (OR 1.67, 95% CI 1.09-2.58, p=0.019), and reference vessel diameter >3.5 mm (OR 5.08, 95% CI 3.32-7.65, p<0.001) were independent predictors of AVDE. In-hospital (8.1% vs. 3.8%, p=0.014) and one-month (10.8% vs. 4.9%, p=0.004) all-cause mortality rates were higher in patients with AVDE. At the long-term follow-up (median: 42 months), both all-cause (21.5% vs. 10.4%, p<0.001) and cardiac mortality rates (18.4% vs. 8.0%, p<0.001) were higher in patients with AVDE.
Conclusion: AVDE is associated with worse clinical outcome at both the short- and long-term follow-up of STEMI patients treated early with p-PCI. |
| first_indexed | 2024-04-10T12:20:13Z |
| format | Article |
| id | doaj.art-797b1b8fc95a4cacbfe66080853d6528 |
| institution | Directory Open Access Journal |
| issn | 1016-5169 |
| language | English |
| last_indexed | 2024-04-10T12:20:13Z |
| publishDate | 2013-09-01 |
| publisher | KARE Publishing |
| record_format | Article |
| series | Türk Kardiyoloji Derneği Arşivi |
| spelling | doaj.art-797b1b8fc95a4cacbfe66080853d65282023-02-15T16:15:29ZengKARE PublishingTürk Kardiyoloji Derneği Arşivi1016-51692013-09-0141648649410.5543/tkda.2013.48265TKDA-48265Predictors and long-term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary interventionVecih Oduncu0Ayhan Erkol1Burak Turan2Taylan Akgün3Can Yücel Karabay4İbrahim Halil Tanboga5Selçuk Pala6Cevat Kırma7Ali Metin Esen8Department of Cardiology, Medical Park Fatih Hospital, İstanbulDepartment of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, TurkeyDepartment of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, TurkeyDepartment of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbulDepartment of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbulDepartment of Cardiology, Atatürk University Faculty of Medicine, ErzurumDepartment of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbulDepartment of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbulDepartment of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbulObjectives: We aimed to identify the predictors of angiographically visible distal embolization (AVDE) during primary percutaneous coronary intervention (p-PCI) as well as to assess its impact on short- and long-term clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI). Study design: We retrospectively enrolled 2007 patients with STEMI who underwent p-PCI. We assessed the clinical and angiographic characteristics of patients in order to identify the predictors of AVDE and compared the outcomes of patients with and without AVDE during p-PCI. Results: Distal embolization developed in 135 (6.7%) patients. Age (for each 10- year increase, Odds Ratio (OR) 1.34, 95% Confidence Interval (CI) 1.16-1.52, p<0.001), treatment of right coronary artery (OR 2.52, 95% CI 1.30-4.87, p=0.034), repeated balloon dilatation (OR 1.84, 95% CI 1.16- 2.94, p=0.009), cut-off occlusion pattern (OR 2.17, 95% CI 1.38-3.42, p=0.001), lesion length >15 mm (OR 1.67, 95% CI 1.09-2.58, p=0.019), and reference vessel diameter >3.5 mm (OR 5.08, 95% CI 3.32-7.65, p<0.001) were independent predictors of AVDE. In-hospital (8.1% vs. 3.8%, p=0.014) and one-month (10.8% vs. 4.9%, p=0.004) all-cause mortality rates were higher in patients with AVDE. At the long-term follow-up (median: 42 months), both all-cause (21.5% vs. 10.4%, p<0.001) and cardiac mortality rates (18.4% vs. 8.0%, p<0.001) were higher in patients with AVDE. Conclusion: AVDE is associated with worse clinical outcome at both the short- and long-term follow-up of STEMI patients treated early with p-PCI.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-48265embolizationtherapeuticcoronary angiographycoronary thrombosis / diagnosismyocardial infarction. |
| spellingShingle | Vecih Oduncu Ayhan Erkol Burak Turan Taylan Akgün Can Yücel Karabay İbrahim Halil Tanboga Selçuk Pala Cevat Kırma Ali Metin Esen Predictors and long-term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary intervention Türk Kardiyoloji Derneği Arşivi embolization therapeutic coronary angiography coronary thrombosis / diagnosis myocardial infarction. |
| title | Predictors and long-term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary intervention |
| title_full | Predictors and long-term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary intervention |
| title_fullStr | Predictors and long-term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary intervention |
| title_full_unstemmed | Predictors and long-term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary intervention |
| title_short | Predictors and long-term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary intervention |
| title_sort | predictors and long term prognostic significance of angiographically visible distal embolization during primary percutaneous coronary intervention |
| topic | embolization therapeutic coronary angiography coronary thrombosis / diagnosis myocardial infarction. |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-48265 |
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