Predictors of In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Recurrent Myocardial Infarction

Jun Shiraishi; Yoshio Kohno; Takahisa Sawada; Mitsuo Takeda; Masayasu Arihara; Masayuki Hyogo; Takakazu Yagi; Takatomo Shima; Takashi Okada; Takeshi Nakamura; Satoaki Matoba; Hiroyuki Yamada; Takeshi Shirayama; Makoto Kitamura; Keizo Furukawa; Hiroaki Matsubara; The AMI-Kyoto Multi-Center Risk Study Group

doi:10.1253/circj.72.1225

Clinical Investigation

Predictors of In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Recurrent Myocardial Infarction

Jun Shiraishi, Yoshio Kohno, Takahisa Sawada, Mitsuo Takeda, Masayasu Arihara, Masayuki Hyogo, Takakazu Yagi, Takatomo Shima, Takashi Okada, Takeshi Nakamura, Satoaki Matoba, Hiroyuki Yamada, Takeshi Shirayama, Makoto Kitamura, Keizo Furukawa, Hiroaki Matsubara, The AMI-Kyoto Multi-Center Risk Study Group

Author information

Jun Shiraishi
Department of Cardiology, Kyoto First Red Cross Hospital
Yoshio Kohno
Department of Cardiology, Kyoto First Red Cross Hospital
Takahisa Sawada
Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
Mitsuo Takeda
Department of Cardiology, Kyoto First Red Cross Hospital
Masayasu Arihara
Department of Emergency Medicine, Kyoto First Red Cross Hospital
Masayuki Hyogo
Department of Cardiology, Kyoto First Red Cross Hospital
Takakazu Yagi
Department of Cardiology, Kyoto First Red Cross Hospital
Takatomo Shima
Department of Cardiology, Kyoto First Red Cross Hospital
Takashi Okada
Department of Cardiology, Kyoto First Red Cross Hospital
Takeshi Nakamura
Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
Satoaki Matoba
Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
Hiroyuki Yamada
Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
Takeshi Shirayama
Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
Makoto Kitamura
Department of Cardiology, Kyoto Second Red Cross Hospital
Keizo Furukawa
Department of Cardiology, Kyoto City Hospital
Hiroaki Matsubara
Department of Cardiology and Vascular Regenerative Medicine, Kyoto Prefectural University School of Medicine
The AMI-Kyoto Multi-Center Risk Study Group

Keywords: Multivessel disease, Primary percutaneous coronary intervention, Prognosis, Recurrent myocardial infarction

JOURNAL FREE ACCESS

2008 Volume 72 Issue 8 Pages 1225-1229

DOI https://doi.org/10.1253/circj.72.1225

Details

Abstract

Background Recurrent acute myocardial infarction (AMI) is a deteriorated condition with high in-hospital morbidity and mortality, but the predictors of in-hospital outcome after primary percutaneous coronary intervention (PCI) for repeat AMI remain unclear. Methods and Results Using the AMI-Kyoto Multi-Center Risk Study database, clinical background, angiographic findings, results of primary PCI, and in-hospital prognosis were retrospectively compared between primary PCI-treated AMI patients with previous myocardial infarction (MI) (repeat-MI patients, n=235) and those without previous MI (first-MI patients, n=1,550). The repeat-MI patients had higher prevalence of Killip class ≥3 at admission, larger number of diseased vessels, and a significantly higher in-hospital mortality rate than the first-MI patients. On multivariate analysis, number of diseased vessels ≥2 or diseased left main trunk (LMT) on initial coronary angiography was the independent positive predictor of in-hospital mortality in the repeat-MI patients, not in the first-MI patients, whereas acquisition of Thrombolysis In Myocardial Infarction 3 flow in the infarct-related artery immediately after primary PCI and elapsed time <24 h were the negative predictors in the first-MI patients, not in the repeat-MI patients. Conclusions Number of diseased vessels ≥2 or diseased LMT on initial coronary angiography is an independent risk factor of in-hospital death in recurrent-AMI patients undergoing primary PCI. (Circ J 2008; 72: 1225 - 1229)

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