One-Year Outcomes after PCI Strategies in Cardiogenic Shock.
Abstract | BACKGROUND: METHODS: RESULTS: As reported previously, at 30 days, the primary end point had occurred in 45.9% of the patients in the culprit-lesion-only PCI group and in 55.4% in the multivessel PCI group (P=0.01). At 1 year, death had occurred in 172 of 344 patients (50.0%) in the culprit-lesion-only PCI group and in 194 of 341 patients (56.9%) in the multivessel PCI group (relative risk, 0.88; 95% confidence interval [CI], 0.76 to 1.01). The rate of recurrent infarction was 1.7% with culprit-lesion-only PCI and 2.1% with multivessel PCI (relative risk, 0.85; 95% CI, 0.29 to 2.50), and the rate of a composite of death or recurrent infarction was 50.9% and 58.4%, respectively (relative risk, 0.87; 95% CI, 0.76 to 1.00). Repeat revascularization occurred more frequently with culprit-lesion-only PCI than with multivessel PCI (in 32.3% of the patients vs. 9.4%; relative risk, 3.44; 95% CI, 2.39 to 4.95), as did rehospitalization for heart failure (5.2% vs. 1.2%; relative risk, 4.46; 95% CI, 1.53 to 13.04). CONCLUSIONS: Among patients with acute myocardial infarction and cardiogenic shock, the risk of death or renal-replacement therapy at 30 days was lower with culprit-lesion-only PCI than with immediate multivessel PCI, and mortality did not differ significantly between the two groups at 1 year of follow-up. (Funded by the European Union Seventh Framework Program and others; CULPRIT- SHOCK ClinicalTrials.gov number, NCT01927549 .).
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Authors | Holger Thiele, Ibrahim Akin, Marcus Sandri, Suzanne de Waha-Thiele, Roza Meyer-Saraei, Georg Fuernau, Ingo Eitel, Peter Nordbeck, Tobias Geisler, Ulf Landmesser, Carsten Skurk, Andreas Fach, Alexander Jobs, Harald Lapp, Jan J Piek, Marko Noc, Tomaž Goslar, Stephan B Felix, Lars S Maier, Janina Stepinska, Keith Oldroyd, Pranas Serpytis, Gilles Montalescot, Olivier Barthelemy, Kurt Huber, Stephan Windecker, Lukas Hunziker, Stefano Savonitto, Patrizia Torremante, Christiaan Vrints, Steffen Schneider, Uwe Zeymer, Steffen Desch, CULPRIT-SHOCK Investigators |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 379
Issue 18
Pg. 1699-1710
(11 01 2018)
ISSN: 1533-4406 [Electronic] United States |
PMID | 30145971
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Topics |
- Aged
- Female
- Follow-Up Studies
- Heart Failure
(epidemiology, etiology)
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Myocardial Infarction
(complications)
- Patient Readmission
- Percutaneous Coronary Intervention
(methods)
- Recurrence
- Renal Insufficiency
(etiology, therapy)
- Renal Replacement Therapy
- Shock, Cardiogenic
(etiology, mortality, therapy)
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