Optimal Timing of Percutaneous Coronary Intervention in Patients With Non-ST-Segment Elevation Myocardial Infarction Complicated by Acute Decompensated Heart Failure (from the Korea Acute Myocardial Infarction Registry-National Institutes of Health [KAMIR-NIH])
- Authors
- Kim, Min Chul; Jeong, Myung Ho; Sim, Doo Sun; Hong, Young Joon; Kim, Ju Han; Ahn, Youngkeun; Ahn, Tae Hoon; Seung, Ki Bae; Choi, Dong-Joo; Kim, Hyo-Soo; Gwon, Hyeon Cheol; Seong, In Whan; Hwang, Kyung Kuk; Chae, Shung Chull; Hur, Seung Ho; Cha, Kwang Soo; Oh, Seok Kyu; Chae, Jei Keon
- Issue Date
- 1-Jun-2018
- Publisher
- EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
- Citation
- AMERICAN JOURNAL OF CARDIOLOGY, v.121, no.11, pp.1285 - 1292
- Journal Title
- AMERICAN JOURNAL OF CARDIOLOGY
- Volume
- 121
- Number
- 11
- Start Page
- 1285
- End Page
- 1292
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/3667
- DOI
- 10.1016/j.amjcard.2018.01.051
- ISSN
- 0002-9149
- Abstract
- The optimal timing of percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI), complicated by acute decompensated heart failure (ADHF), is unclear. A total of 1,027 patients with NSTEMI complicated by ADHF who underwent successful PCI were analyzed using a Korean multicenter registry. All patients were divided into 4 groups by the timing of PCI: group 1 (PCI < 2 hour after admission, n =149), group 2 (2 to 24 hours, n = 577), group 3 (24 to 72 hours, n = 189), and group 4 (>= 72 hours, n =112). We analyzed the incidences of 12-month mortality, nonfatal myocardial infarction (MI), target-vessel revascularization, and rehospitalization because of HF. The prevalence of ADHF in patients with NSTEMI was 15.2% at initial presentation, and in-hospital mortality was higher in group 1 than in the other groups. There were no significant differences in mortality, nonfatal MI, target-vessel revascularization, or rehospitalization for HF during the 12-month follow-up between groups, regardless of initial PCI timing, except for a higher 12-month mortality in patients who received PCI within 24 hours (vs >= 24 hours) (hazard ratio 1.52, 95% confidence interval 1.09 to 2.29, p = 0.046). Early PCI did not reduce adverse clinical outcomes in patients with NSTEMI complicated by ADHF. Delayed PCI after stabilization may be reasonable in such high-risk patients. (C) 2018 Elsevier Inc. All rights reserved.
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