Infarct Artery Distribution and Clinical Outcomes in Occluded Artery Trial Subjects Presenting With Non ST-Segment Elevation Myocardial Infarction (from the Long-Term Follow-up of Occluded Artery Trial [OAT])

Infarct Artery Distribution and Clinical Outcomes in Occluded Artery Trial Subjects Presenting With Non ST-Segment Elevation Myocardial Infarction (from the Long-Term Follow-up of Occluded Artery Trial [OAT])

Autor Menon, Venu Google Scholar
Ruzyllo, Witold Google Scholar
Carvalho, Antonio C. Autor UNIFESP Google Scholar
Almeida de Sousa, Jose Marconi Autor UNIFESP Google Scholar
Forman, Sandra A. Google Scholar
Jaworska, Krystyna Google Scholar
Lamas, Gervasio A. Google Scholar
Roik, Marek Google Scholar
Thuaire, Christophe Google Scholar
Turgeman, Yoav Google Scholar
Hochman, Judith S. Google Scholar
Instituição Cleveland Clin
Natl Inst Cardiol
Universidade Federal de São Paulo (UNIFESP)
Clin Trials & Surveys Corp
Reg Hosp
Columbia Univ
Med Univ Warsaw
Ctr Hop Louis Pasteur
Technion Israel Inst Technol
NYU
Resumo We hypothesized that the insensitivity of the electrocardiogram. in identifying acute circumflex occlusion would result in differences in the distribution of the infarct-related artery (IRA) between patients with non ST-segment elevation myocardial infarction (NSTEMI) and STEMI enrolled in the Occluded Artery Trial. We also sought to evaluate the effect of percutaneous coronary intervention to the IRA on the clinical outcomes for patients with NSTEMI. Overall, those with NSTEMI constituted 13% (n = 283) of the trial population. the circumflex IRA was overrepresented in the NSTEMI group compared to the STEM! group (42.5 vs 11.2%; p < 0.0001). the 7-year clinical outcomes for the patients with NSTEMI randomized to percutaneous coronary intervention and optimal medical therapy versus optimal medical therapy alone were similar for the primary composite of death, myocardial infarction, and class W congestive heart failure (22.3% vs 20.2%, hazard ratio 1.20, 99% confidence interval 0.60 to 2.40; p = 0.51) and the individual end points of death (13.8% vs 17.0%, hazard ratio 0.82, 99% confidence interval 0.37 to 1.84; p = 0.53), myocardial infarction (6.1 vs 5.1%, hazard ratio 1.11, 99% confidence interval 0.28 to 4.41; p = 0.84), and class IV congestive heart failure (6.7% vs 6.0%, hazard ratio 1.50, 99% confidence interval 0.37 to 6.02; p = 0.45). No interaction was seen between the electro-cardiographically determined myocardial infarction type and treatment effect (p = NS). in conclusion, the occluded circumflex IRA is overrepresented in the NSTEMI population. Consistent with the overall trial results, stable patients with NSTEMI and a totally occluded IRA did not benefit from randomization to percutaneous coronary intervention. (C) 2013 Elsevier Inc. All rights reserved. (Am J Cardiol 2013;111:930-935)
Idioma Inglês
Financiador National Heart, Lung, and Blood Institute, Bethesda, Maryland
Número do financiamento National Heart, Lung, and Blood Institute, Bethesda, Maryland: U01 HL062509
National Heart, Lung, and Blood Institute, Bethesda, Maryland: U01 HL062511
Data de publicação 2013-04-01
Publicado em American Journal of Cardiology. Bridgewater: Excerpta Medica Inc-Elsevier B.V., v. 111, n. 7, p. 930-935, 2013.
ISSN 0002-9149 (Sherpa/Romeo, fator de impacto)
Publicador Elsevier B.V.
Extensão 930-935
Fonte http://dx.doi.org/10.1016/j.amjcard.2012.12.009
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000316923700002
Endereço permanente http://repositorio.unifesp.br/handle/11600/36154

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