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- Title
Non-culprit left main coronary artery disease in acute myocardial infarction complicated by cardiogenic shock.
- Authors
Park, Ik Hyun; Jang, Woo Jin; Oh, Ju Hyeon; Yang, Jeong Hoon; Song, Young Bin; Hahn, Joo-Yong; Choi, Seung-Hyuk; Gwon, Hyeon-Cheol; Ahn, Chul-Min; Yu, Cheol Woong; Kim, Hyun-Joong; Bae, Jang-Whan; Kwon, Sung Uk; Lee, Hyun-Jong; Lee, Wang Soo; Jeong, Jin-Ok; Park, Sang-Don
- Abstract
Objectives: We evaluated the clinical impact of residual non-culprit left main coronary artery disease (LMCAD) on prognosis in patients undergoing emergent percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). Methods: A total of 429 patients who underwent PCI for AMI complicated by CS was enrolled from 12 centers in the Republic of Korea. The patients were divided into two groups according to presence of non-culprit LMCAD or not: the LMCAD non-culprit group (n = 43) and the no LMCAD group (n = 386). Primary outcome was major adverse cardiac event (MACE, defined as a composite of cardiac death, myocardial infarction, or repeat revascularization). Propensity score matching analysis was performed to reduce selection bias and potential confounding factors. Results: During a 12-month follow-up, a total of 168 MACEs occurred (LMCAD non-culprit group, 17 [39.5%] vs. no LMCAD group, 151 [39.1%]). Multivariate analysis revealed no significant difference in the incidence of MACE at 12 months between the LMCAD non-culprit and no LMCAD groups (adjusted hazard ratio [HR] 0.97, 95% confidence interval [CI] 0.58 to 1.62, p = 0.901). After propensity score matching, the incidence of MACE was still similar between the two groups (HR 0.64; 95% CI 0.33 to 1.23; p = 0.180). The similarity of MACEs between the two groups was consistent across a variety of subgroups. Conclusions: After adjusting for baseline differences, residual non-culprit LMCAD does not appear to increase the risk of MACEs at 12 months in patients undergoing emergent PCI for AMI complicated by CS.
- Subjects
SOUTH Korea; AMERICAN Megatrends Inc.; PROPENSITY score matching; MYOCARDIAL infarction; CARDIOGENIC shock; CORONARY artery disease; CARDIOMYOPATHIES; MAJOR adverse cardiovascular events
- Publication
PLoS ONE, 2023, Vol 17, Issue 3, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0276711