Late reopening of an occluded infarct related artery improves left ventricular function and long term clinical outcome.

Abstract

OBJECTIVE:

To assess effects on left ventricular (LV) function and on long term clinical outcome of late percutaneous transluminal coronary angioplasty (PTCA) of a chronically occluded infarct related artery.

METHODS:

65 patients who underwent PTCA a mean (SD) of 6.0 (1.2) months after a previous myocardial infarction were divided in two groups according to dilated artery patency status after PTCA: group 1 (35 patients with TIMI (thrombolysis in myocardial infarction) grade 3 flow) and group 2 (30 patients with TIMI grade 0-2 flow). Echocardiography was performed at admission and at six months' follow up. A three year follow up was conducted with major adverse cardiac events (MACE) as end points.

RESULTS:

At follow up, group 1 had improved global LV ejection fraction (48.7% v 43.6%, p < 0.001) and LV indexed end diastolic and end systolic volumes (75 v 86 ml/m(2) and 40 v 53 ml/m(2), respectively, p = 0.011) compared with group 2. Kaplan-Meier analysis showed a higher incidence of cardiac death (p = 0.02) and MACE (p < 0.0001) in group 2. TIMI 3 after PTCA was an independent predictor of event-free survival at follow up.

CONCLUSION:

Late PTCA of a chronically occluded infarct related artery improves LV function, reduces cardiac death, and improves long term clinical outcome.

• Authors: F Piscione, G Galasso, G De Luca, G Marrazzo, G Sarno, O Viola, D Accardo, M Chiariello
• Journal: Heart (British Cardiac Society) (Heart) Vol. 91 Issue 5 Pg. 646-51 (May 2005) ISSN: 1468-201X [Electronic] England
• PMID: 15831653 (Publication Type: Evaluation Study, Journal Article)

Topics

• Angioplasty, Balloon, Coronary (methods, mortality)
• Coronary Angiography (methods)
• Coronary Restenosis (prevention & control)
• Coronary Stenosis (diagnostic imaging, therapy)
• Death, Sudden, Cardiac (etiology)
• Disease-Free Survival
• Echocardiography (methods)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (diagnostic imaging, therapy)
• Myocardial Reperfusion (methods, mortality)
• Treatment Outcome
• Ventricular Dysfunction, Left (diagnostic imaging, prevention & control)