Predictors of In-Hospital Prognosis After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction Requiring Mechanical Support Devices

Jun Shiraishi; Yoshio Kohno; Takahisa Sawada; Masayoshi Kimura; Makoto Ariyoshi; Akihiro Matsui; Mitsuo Takeda; Masayasu Arihara; Masayuki Hyogo; Takatomo Shima; Takashi Okada; Takeshi Nakamura; Satoaki Matoba; Hiroyuki Yamada; Akiyoshi Matsumuro; Makoto Kitamura; Keizo Furukawa; Hiroaki Matsubara; The AMI-Kyoto Multi-Center Risk Study Group

doi:10.1253/circj.CJ-09-0774

Ischemic Heart Disease

Predictors of In-Hospital Prognosis After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction Requiring Mechanical Support Devices

Jun Shiraishi, Yoshio Kohno, Takahisa Sawada, Masayoshi Kimura, Makoto Ariyoshi, Akihiro Matsui, Mitsuo Takeda, Masayasu Arihara, Masayuki Hyogo, Takatomo Shima, Takashi Okada, Takeshi Nakamura, Satoaki Matoba, Hiroyuki Yamada, Akiyoshi Matsumuro, 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 Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
Masayoshi Kimura
Department of Cardiology, Kyoto First Red Cross Hospital
Makoto Ariyoshi
Department of Cardiology, Kyoto First Red Cross Hospital
Akihiro Matsui
Department of Cardiology, Kyoto First Red Cross Hospital
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
Takatomo Shima
Department of Cardiology, Kyoto First Red Cross Hospital
Takashi Okada
Department of Cardiology, Kyoto First Red Cross Hospital
Takeshi Nakamura
Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
Satoaki Matoba
Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
Hiroyuki Yamada
Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
Akiyoshi Matsumuro
Emergency 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 Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
The AMI-Kyoto Multi-Center Risk Study Group

Keywords: Intra-aortic balloon pumping, Percutaneous cardiopulmonary support, Primary percutaneous coronary intervention, Multivessel disease

JOURNAL FREE ACCESS

2010 Volume 74 Issue 6 Pages 1152-1157

DOI https://doi.org/10.1253/circj.CJ-09-0774

View "Advance Publication" version (April 3, 2010).

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Abstract

Background: Predictors of in-hospital outcome after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) requiring mechanical support devices such as intra-aortic balloon pumping (IABP) and/or percutaneous cardiopulmonary support (PCPS) 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 requiring mechanical assist devices (with-IABP/PCPS patients, n=275) and those without (without-IABP/PCPS patients, n=1,510). The with-IABP/PCPS patients were more likely to have a larger number of diseased vessels, lower Thrombolysis In Myocardial Infarction (TIMI) grade in the infarct-related artery (IRA) before/after primary PCI, and a significantly higher in-hospital mortality rate than the without-IABP/PCPS patients. On multivariate analysis, the number of diseased vessels ≥2 or diseased left main trunk (LMT) at initial coronary angiography (CAG) was the independent positive predictor of the in-hospital mortality in the with-IABP/PCPS patients, not in the without-IABP/PCPS patients, whereas acquisition of TIMI 3 flow in the IRA immediately after primary PCI was the negative predictor in the without-IABP/PCPS patients, not in the with-IABP/PCPS patients. Conclusions: The number of diseased vessels ≥2 or diseased LMT at initial CAG is an independent risk factor of in-hospital death in primary PCI-treated AMI patients requiring mechanical support devices. (Circ J 2010; 74: 1152 - 1157)

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