Frequency, clinical and angiographic characteristics, and outcomes of high-risk non-ST-segment elevation acute coronary syndromes patients with left circumflex culprit lesions
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie, Research Support, N.I.H., Extramural, práce podpořená grantem
Grantová podpora
HL069749-09
NHLBI NIH HHS - United States
PubMed
26587725
DOI
10.1016/j.ijcard.2015.11.036
PII: S0167-5273(15)30846-9
Knihovny.cz E-zdroje
- Klíčová slova
- Acute coronary syndromes, Infarct size, Left circumflex artery,
- MeSH
- akutní koronární syndrom diagnostické zobrazování epidemiologie terapie MeSH
- časové faktory MeSH
- elektrokardiografie * MeSH
- eptifibatid MeSH
- incidence MeSH
- inhibitory agregace trombocytů aplikace a dávkování MeSH
- intravenózní infuze MeSH
- koronární angiografie * MeSH
- koronární angioplastika metody MeSH
- koronární cévy diagnostické zobrazování chirurgie MeSH
- lidé MeSH
- míra přežití trendy MeSH
- peptidy aplikace a dávkování MeSH
- prognóza MeSH
- rizikové faktory MeSH
- senioři MeSH
- trombocytový glykoproteinový komplex IIb-IIIa antagonisté a inhibitory MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
- Nový Zéland epidemiologie MeSH
- Spojené státy americké epidemiologie MeSH
- Názvy látek
- eptifibatid MeSH
- inhibitory agregace trombocytů MeSH
- peptidy MeSH
- trombocytový glykoproteinový komplex IIb-IIIa MeSH
BACKGROUND: The relationship between culprit vessel, infarct size, and outcomes in non-ST-segment elevation acute coronary syndromes (NSTE ACS) is unclear. In some reports, the left circumflex artery (LCX) was more often the culprit at angiography than the right coronary artery (RCA) or left anterior descending artery (LAD), and infarcts were larger with LCX culprits. METHODS: We determined culprit vessel frequency and initial patency (TIMI flow grade), median fold elevation of peak troponin above the upper limit of normal, and outcomes (30-day death or myocardial infarction [MI] and 1-year mortality) by culprit vessel in high-risk NSTE ACS patients in the EARLY ACS trial. RESULTS: Of 9406 patients, 2066 (22.0%) had angiographic core laboratory data. We evaluated 1774 patients for whom the culprit artery was not the left main, a bypass graft, or branch vessel. The culprit was the LCX in 560 (31.6%), LAD in 653 (36.8%), and RCA in 561 (31.6%) patients. There were fewer women (24.1%) and more prior MI (25.5%) among patients with a culprit LCX compared with those with a culprit LAD or RCA. Patients with LCX (21.2%) and RCA (27.5%) culprits more often had an occluded artery (TIMI 0/1) than did those with LAD (11.3%). Peak troponin elevation was significantly higher for LCX than RCA or LAD culprits. LCX culprit vessels were not associated with worse 30-day or 1-year outcomes in adjusted models. CONCLUSIONS: Among patients with NSTE ACS, the frequencies of LCX, LAD, and RCA culprits were similar. Although LCX lesions were associated with higher peak troponin levels, there was no difference in short- or intermediate-term outcomes by culprit artery.
3rd Faculty of Medicine Charles University Prague Czech Republic
Department of Cardiology Hospital Clinic Barcelona Spain
Department of Medicine New York University School of Medicine New York NY USA
Department of Medicine Stanford University Stanford CA USA
Division of Cardiology and Duke Clinical Research Institute Durham NC USA
Division of Cardiology Hospital 'De Weezenlanden' Isala Klinieken Zwolle The Netherlands
Green Lane Cardiovascular Service Auckland New Zealand
Herzzentrum Ludwigshafen Germany
TIMI Study Group Brigham and Women's Hospital Boston MA USA
Tufts University School of Medicine Baystate Medical Center Springfield MA USA
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