Effects of timing, location and definition of reinfarction on mortality in patients with totally occluded infarct related arteries late after myocardial infarction
Identifieur interne : 004189 ( Main/Exploration ); précédent : 004188; suivant : 004190Effects of timing, location and definition of reinfarction on mortality in patients with totally occluded infarct related arteries late after myocardial infarction
Auteurs : Christopher Adlbrecht [Autriche] ; Kurt Huber [Autriche] ; Harmony R. Reynolds [États-Unis] ; Antonio C. Carvalho [Brésil] ; Vladimír Dzavik [Canada] ; Philippe Gabriel Steg [France] ; LI LIU [États-Unis] ; Paolo Marino [Italie] ; Camille A. Pearte [États-Unis] ; James M. Rankin [Australie] ; Harvey D. White [Nouvelle-Zélande] ; Gervasio A. Lamasl [Nouvelle-Zélande] ; Judith S. Hochman [États-Unis]Source :
- International journal of cardiology [ 0167-5273 ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Infarctus du myocarde, Occlusion coronarienne.
- mortalité : Infarctus du myocarde.
- Pascal (Inist)
- Adulte d'âge moyen, Facteurs temps, Femelle, Humains, Infarctus du myocarde, Mâle, Occlusion coronarienne, Pathologie de l'appareil circulatoire, Récidive, Timing, Etude temporelle, Définition, Mortalité, Pronostic, Epidémiologie, Homme, Malade, Artère, Tardif, Revascularisation, Cardiologie, Études de suivi.
- Wicri :
English descriptors
- KwdEn :
- Artery, Cardiology, Cardiovascular disease, Coronary Occlusion (complications), Coronary Occlusion (pathology), Coronary Occlusion (therapy), Definition, Epidemiology, Female, Follow-Up Studies, Human, Humans, Late, Male, Middle Aged, Mortality, Myocardial Infarction (complications), Myocardial Infarction (mortality), Myocardial Infarction (pathology), Myocardial Infarction (therapy), Myocardial infarction, Patient, Prognosis, Recurrence, Revascularization, Temporal study, Time Factors, Timing.
- MESH :
- complications : Coronary Occlusion, Myocardial Infarction.
- mortality : Myocardial Infarction.
- pathology : Coronary Occlusion, Myocardial Infarction.
- therapy : Coronary Occlusion, Myocardial Infarction.
- Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Time Factors.
Abstract
Background: The Occluded Artery Trial (OAT) randomized stable patients (n = 2201) >24 h (calendar days 3-28) after myocardial infarction (MI) with totally occluded infarct-related arteries (IRA), to percutaneous coronary intervention (PCI) with optimal medical therapy, or optimal medical therapy alone (MED). PCI had no impact on the composite of death, reinfarction, or class IV heart failure over extended follow-up of up to 9 years. We evaluated the impact of early and late reinfarction and definition of MI on subsequent mortality. Methods and results: Reinfarction was adjudicated according to an adaptation of the 2007 universal definition of MI and the OAT definition (≥2 of the following - symptoms, EKG and biomarkers). Cox regression models were used to analyze the effect of post-randomization reinfarction and baseline variables on time to death. After adjustment for baseline characteristics the 169 (PCI: n = 95; MED: n = 74) patients who developed reinfarction by the universal definition had a 4.15-fold (95% CI 3.03-5.69, p < 0.001) increased risk of death compared to patients without reinfarction. This risk was similar for both treatment groups (interaction p = 0.26) and when MI was defined by the stricter OAT criteria. Reinfarctions occurring within 6 months of randomization had similar impact on mortality as reinfarctions occurring later, and the impact of reinfarction due to the same IRA and a different epicardial vessel was similar. Conclusions: For stable post-MI patients with totally occluded infarct arteries, reinfarction significantly independently increased the risk of death regardless of the initial management strategy (PCI vs. MED), reinfarction definition, location and early or late occurrence.
Url:
Affiliations:
- Australie, Autriche, Brésil, Canada, France, Italie, Nouvelle-Zélande, États-Unis
- Maryland, Vienne (Autriche), État de New York, État de São Paulo, Île-de-France
- Baltimore, Paris, São Paulo, Vienne (Autriche)
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Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Effects of timing, location and definition of reinfarction on mortality in patients with totally occluded infarct related arteries late after myocardial infarction</title>
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<wicri:noRegion>Green Lane Cardiovascular Service</wicri:noRegion>
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</author>
<author><name sortKey="Hochman, Judith S" sort="Hochman, Judith S" uniqKey="Hochman J" first="Judith S." last="Hochman">Judith S. Hochman</name>
<affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Cardiovascular Clinical Research Center, New York University School of Medicine</s1>
<s2>New York</s2>
<s3>USA</s3>
<sZ>3 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">International journal of cardiology</title>
<title level="j" type="abbreviated">Int. j. cardiol.</title>
<idno type="ISSN">0167-5273</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">International journal of cardiology</title>
<title level="j" type="abbreviated">Int. j. cardiol.</title>
<idno type="ISSN">0167-5273</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Artery</term>
<term>Cardiology</term>
<term>Cardiovascular disease</term>
<term>Coronary Occlusion (complications)</term>
<term>Coronary Occlusion (pathology)</term>
<term>Coronary Occlusion (therapy)</term>
<term>Definition</term>
<term>Epidemiology</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Human</term>
<term>Humans</term>
<term>Late</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Mortality</term>
<term>Myocardial Infarction (complications)</term>
<term>Myocardial Infarction (mortality)</term>
<term>Myocardial Infarction (pathology)</term>
<term>Myocardial Infarction (therapy)</term>
<term>Myocardial infarction</term>
<term>Patient</term>
<term>Prognosis</term>
<term>Recurrence</term>
<term>Revascularization</term>
<term>Temporal study</term>
<term>Time Factors</term>
<term>Timing</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Infarctus du myocarde ()</term>
<term>Infarctus du myocarde (anatomopathologie)</term>
<term>Infarctus du myocarde (mortalité)</term>
<term>Mâle</term>
<term>Occlusion coronarienne ()</term>
<term>Occlusion coronarienne (anatomopathologie)</term>
<term>Récidive</term>
<term>Études de suivi</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Infarctus du myocarde</term>
<term>Occlusion coronarienne</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronary Occlusion</term>
<term>Myocardial Infarction</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Myocardial Infarction</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infarctus du myocarde</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Coronary Occlusion</term>
<term>Myocardial Infarction</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronary Occlusion</term>
<term>Myocardial Infarction</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Recurrence</term>
<term>Time Factors</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Humains</term>
<term>Infarctus du myocarde</term>
<term>Mâle</term>
<term>Occlusion coronarienne</term>
<term>Pathologie de l'appareil circulatoire</term>
<term>Récidive</term>
<term>Timing</term>
<term>Etude temporelle</term>
<term>Définition</term>
<term>Mortalité</term>
<term>Pronostic</term>
<term>Epidémiologie</term>
<term>Homme</term>
<term>Malade</term>
<term>Artère</term>
<term>Tardif</term>
<term>Revascularisation</term>
<term>Cardiologie</term>
<term>Études de suivi</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Mortalité</term>
<term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background: The Occluded Artery Trial (OAT) randomized stable patients (n = 2201) >24 h (calendar days 3-28) after myocardial infarction (MI) with totally occluded infarct-related arteries (IRA), to percutaneous coronary intervention (PCI) with optimal medical therapy, or optimal medical therapy alone (MED). PCI had no impact on the composite of death, reinfarction, or class IV heart failure over extended follow-up of up to 9 years. We evaluated the impact of early and late reinfarction and definition of MI on subsequent mortality. Methods and results: Reinfarction was adjudicated according to an adaptation of the 2007 universal definition of MI and the OAT definition (≥2 of the following - symptoms, EKG and biomarkers). Cox regression models were used to analyze the effect of post-randomization reinfarction and baseline variables on time to death. After adjustment for baseline characteristics the 169 (PCI: n = 95; MED: n = 74) patients who developed reinfarction by the universal definition had a 4.15-fold (95% CI 3.03-5.69, p < 0.001) increased risk of death compared to patients without reinfarction. This risk was similar for both treatment groups (interaction p = 0.26) and when MI was defined by the stricter OAT criteria. Reinfarctions occurring within 6 months of randomization had similar impact on mortality as reinfarctions occurring later, and the impact of reinfarction due to the same IRA and a different epicardial vessel was similar. Conclusions: For stable post-MI patients with totally occluded infarct arteries, reinfarction significantly independently increased the risk of death regardless of the initial management strategy (PCI vs. MED), reinfarction definition, location and early or late occurrence.</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>Autriche</li>
<li>Brésil</li>
<li>Canada</li>
<li>France</li>
<li>Italie</li>
<li>Nouvelle-Zélande</li>
<li>États-Unis</li>
</country>
<region><li>Maryland</li>
<li>Vienne (Autriche)</li>
<li>État de New York</li>
<li>État de São Paulo</li>
<li>Île-de-France</li>
</region>
<settlement><li>Baltimore</li>
<li>Paris</li>
<li>São Paulo</li>
<li>Vienne (Autriche)</li>
</settlement>
</list>
<tree><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Adlbrecht, Christopher" sort="Adlbrecht, Christopher" uniqKey="Adlbrecht C" first="Christopher" last="Adlbrecht">Christopher Adlbrecht</name>
</region>
<name sortKey="Huber, Kurt" sort="Huber, Kurt" uniqKey="Huber K" first="Kurt" last="Huber">Kurt Huber</name>
</country>
<country name="États-Unis"><region name="État de New York"><name sortKey="Reynolds, Harmony R" sort="Reynolds, Harmony R" uniqKey="Reynolds H" first="Harmony R." last="Reynolds">Harmony R. Reynolds</name>
</region>
<name sortKey="Hochman, Judith S" sort="Hochman, Judith S" uniqKey="Hochman J" first="Judith S." last="Hochman">Judith S. Hochman</name>
<name sortKey="Li Liu" sort="Li Liu" uniqKey="Li Liu" last="Li Liu">LI LIU</name>
<name sortKey="Pearte, Camille A" sort="Pearte, Camille A" uniqKey="Pearte C" first="Camille A." last="Pearte">Camille A. Pearte</name>
</country>
<country name="Brésil"><region name="État de São Paulo"><name sortKey="Carvalho, Antonio C" sort="Carvalho, Antonio C" uniqKey="Carvalho A" first="Antonio C." last="Carvalho">Antonio C. Carvalho</name>
</region>
</country>
<country name="Canada"><noRegion><name sortKey="Dzavik, Vladimir" sort="Dzavik, Vladimir" uniqKey="Dzavik V" first="Vladimír" last="Dzavik">Vladimír Dzavik</name>
</noRegion>
</country>
<country name="France"><region name="Île-de-France"><name sortKey="Steg, Philippe Gabriel" sort="Steg, Philippe Gabriel" uniqKey="Steg P" first="Philippe Gabriel" last="Steg">Philippe Gabriel Steg</name>
</region>
<name sortKey="Steg, Philippe Gabriel" sort="Steg, Philippe Gabriel" uniqKey="Steg P" first="Philippe Gabriel" last="Steg">Philippe Gabriel Steg</name>
<name sortKey="Steg, Philippe Gabriel" sort="Steg, Philippe Gabriel" uniqKey="Steg P" first="Philippe Gabriel" last="Steg">Philippe Gabriel Steg</name>
</country>
<country name="Italie"><noRegion><name sortKey="Marino, Paolo" sort="Marino, Paolo" uniqKey="Marino P" first="Paolo" last="Marino">Paolo Marino</name>
</noRegion>
</country>
<country name="Australie"><noRegion><name sortKey="Rankin, James M" sort="Rankin, James M" uniqKey="Rankin J" first="James M." last="Rankin">James M. Rankin</name>
</noRegion>
</country>
<country name="Nouvelle-Zélande"><noRegion><name sortKey="White, Harvey D" sort="White, Harvey D" uniqKey="White H" first="Harvey D." last="White">Harvey D. White</name>
</noRegion>
<name sortKey="Lamasl, Gervasio A" sort="Lamasl, Gervasio A" uniqKey="Lamasl G" first="Gervasio A." last="Lamasl">Gervasio A. Lamasl</name>
</country>
</tree>
</affiliations>
</record>
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