AI Article Synopsis

  • * Out of 90 patients studied, those with RVBC experienced significantly higher rates of major adverse cardiac events (MACEs) compared to those without RVBC, highlighting the adverse impact of RVBC.
  • * Both RVBC and baseline CKD emerged as strong predictors of poor prognosis, with CKD showing an even greater negative effect when combined with RVBC during follow-up.

Article Abstract

Background: Right ventricular branch compromise (RVBC) following percutaneous coronary intervention (PCI) in patients with acute inferior myocardial infarction (AIMI) is associated with short-term adverse clinical outcomes. Chronic kidney disease (CKD) is also known to be a major risk factor after PCI in AIMI. However, little is known about the impact of RVBC and CKD on long-term prognosis.

Methods: From January 2009 to January 2019, we retrospectively enrolled 90 consecutive patients with ST-elevation AIMI who had a culprit lesion in the proximal-to-mid right coronary arteries and underwent PCI in our institution. After the measurement of the Thrombolysis in Myocardial Infarction frame counts in RV branches using post-PCI angiography, we divided them into two groups (RVBC, n = 49; non-RVBC, n = 41), and investigated their long-term prognosis for 43±31 months. The primary endpoint was the incidence of major adverse cardiac events (MACEs), including all-cause death, nonfatal MI, congestive heart failure requiring hospitalization, and life-threatening arrhythmia.

Results: Both groups showed similar clinical characteristics; however, the baseline right ventricular function after PCI was significantly worse in RVBC than in non- RVBC. Twenty-four MACEs occurred during the follow-up (RVBC vs. non-RVBC: 37% vs. 14%, p = 0.002). In the multivariate analysis, both RVBC and baseline CKD were powerful predictors of MACEs (RVBC: hazard ratio [HR] 2.85, CKD: HR 2.29). Baseline CKD showed higher hazard ratios of MACEs in RVBC (CKD: HR 7.19 vs. non-CKD: HR 0.24).

Conclusions: The prognoses of RVBC after primary PCI in patients with AIMI were poor. Baseline CKD and RVBC were associated with poor long-term clinical outcomes.

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Source
http://dx.doi.org/10.1016/j.jjcc.2021.06.005DOI Listing

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