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Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease

In this study, we identified several factors related to left ventricular remodeling (LVR) and examined the impact of LVR on the prognosis of patients with ST-elevated myocardial infarction and multivessel disease treated with complete (CR) or incomplete (IR) revascularization. LVR was defined as an...

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Autores principales: Kim, Min Chul, Lim, Yongwhan, Ahn, Youngkeun, Ahn, Joon Ho, Lee, Seung Hun, Hyun, Dae Young, Cho, Kyung Hoon, Sim, Doo Sun, Hong, Young Joon, Kim, Ju Han, Jeong, Myung Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9656271/
https://www.ncbi.nlm.nih.gov/pubmed/36362481
http://dx.doi.org/10.3390/jcm11216252
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author Kim, Min Chul
Lim, Yongwhan
Ahn, Youngkeun
Ahn, Joon Ho
Lee, Seung Hun
Hyun, Dae Young
Cho, Kyung Hoon
Sim, Doo Sun
Hong, Young Joon
Kim, Ju Han
Jeong, Myung Ho
author_facet Kim, Min Chul
Lim, Yongwhan
Ahn, Youngkeun
Ahn, Joon Ho
Lee, Seung Hun
Hyun, Dae Young
Cho, Kyung Hoon
Sim, Doo Sun
Hong, Young Joon
Kim, Ju Han
Jeong, Myung Ho
author_sort Kim, Min Chul
collection PubMed
description In this study, we identified several factors related to left ventricular remodeling (LVR) and examined the impact of LVR on the prognosis of patients with ST-elevated myocardial infarction and multivessel disease treated with complete (CR) or incomplete (IR) revascularization. LVR was defined as an LV end-diastolic diameter >55 mm. A total of 262 patients without LVR at presentation were followed up with echocardiography between 1 month and 1 year. The primary outcome was a composite of all-cause death (AD), MI, and heart failure (HF), referred to as a major adverse cardiovascular endpoint (MACE). Then, each variable was analyzed as a secondary outcome. Follow-up echocardiography identified 26 patients (9.9%) with LVR. LVR was associated with an initial LV ejection fraction <50%, Killip 3 disease at presentation, and a peak troponin I level >70 mg/dL. Survival analysis showed an association between LVR and adverse outcomes only in the IR group, in which the adjusted hazard ratio (HR) was increased for the MACE (HR = 3.22, 95% confidence interval (CI) = 1.19–8.71, p = 0.002) and HF (HR = 21.37, 95% CI = 4.47–102.09, p< 0.001), but not for the CR group. In STEMI with MVD, LVR within the first year after percutaneous coronary intervention was associated with worse outcomes in the IR but not the CR group.
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spelling pubmed-96562712022-11-15 Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease Kim, Min Chul Lim, Yongwhan Ahn, Youngkeun Ahn, Joon Ho Lee, Seung Hun Hyun, Dae Young Cho, Kyung Hoon Sim, Doo Sun Hong, Young Joon Kim, Ju Han Jeong, Myung Ho J Clin Med Article In this study, we identified several factors related to left ventricular remodeling (LVR) and examined the impact of LVR on the prognosis of patients with ST-elevated myocardial infarction and multivessel disease treated with complete (CR) or incomplete (IR) revascularization. LVR was defined as an LV end-diastolic diameter >55 mm. A total of 262 patients without LVR at presentation were followed up with echocardiography between 1 month and 1 year. The primary outcome was a composite of all-cause death (AD), MI, and heart failure (HF), referred to as a major adverse cardiovascular endpoint (MACE). Then, each variable was analyzed as a secondary outcome. Follow-up echocardiography identified 26 patients (9.9%) with LVR. LVR was associated with an initial LV ejection fraction <50%, Killip 3 disease at presentation, and a peak troponin I level >70 mg/dL. Survival analysis showed an association between LVR and adverse outcomes only in the IR group, in which the adjusted hazard ratio (HR) was increased for the MACE (HR = 3.22, 95% confidence interval (CI) = 1.19–8.71, p = 0.002) and HF (HR = 21.37, 95% CI = 4.47–102.09, p< 0.001), but not for the CR group. In STEMI with MVD, LVR within the first year after percutaneous coronary intervention was associated with worse outcomes in the IR but not the CR group. MDPI 2022-10-23 /pmc/articles/PMC9656271/ /pubmed/36362481 http://dx.doi.org/10.3390/jcm11216252 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Min Chul
Lim, Yongwhan
Ahn, Youngkeun
Ahn, Joon Ho
Lee, Seung Hun
Hyun, Dae Young
Cho, Kyung Hoon
Sim, Doo Sun
Hong, Young Joon
Kim, Ju Han
Jeong, Myung Ho
Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease
title Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease
title_full Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease
title_fullStr Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease
title_full_unstemmed Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease
title_short Incidence, Predictive Factors and Long-Term Clinical Impact of Left Ventricular Remodeling According to the Completeness of Revascularization in Patients with ST-Elevation Myocardial Infarction and Multivessel Disease
title_sort incidence, predictive factors and long-term clinical impact of left ventricular remodeling according to the completeness of revascularization in patients with st-elevation myocardial infarction and multivessel disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9656271/
https://www.ncbi.nlm.nih.gov/pubmed/36362481
http://dx.doi.org/10.3390/jcm11216252
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