TCT-216 Predictors Of Patient-Oriented And Device-Oriented Outcomes Among Patients Undergoing Primary Percutaneous Coronary Intervention

Masanori Taniwaki, Giulio G. Stefanini, Lorenz Raber, Henning Kelbaek, Miodrag C. Ostojic, Andreas Baumbach, David Tüller, Clemens von Birgelen, Marco Roffi, Giovanni Pedrazzini, Ran Kornowski, Klaus Weber, Dik Heg, Christian M. Matter, Thomas F. Luescher, Bernard Meier, Peter Jüni, Patrick W. Serruys, Stephan Windecker

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Background: Treatment of STEMI has considerably evolved over the past 2 decades. However, predictors of adverse events after STEMI are mostly based on early studies without consistent use of reperfusion therapy, P2Y12 inhibitors, and drug-eluting stent implantation. We aimed to identify predictors of adverse events among patients with ST-elevation myocardial infarction (STEMI) undergoing contemporary primary percutaneous coronary intervention (PCI).

Methods: Individual data of 2655 patients from 2 primary PCI trials (EXAMINATION, N=1504; COMFORTABLE-AMI, N=1161) with identical endpoint definition and event adjudication were pooled. Predictors of patient-oriented (death or reinfarction) and device-oriented (definite stent thrombosis [ST] and target-lesion revascularization [TLR]) outcomes at 1 year were identified by multivariable Cox regressions analysis.

Results: Killip class III/IV was the strongest predictor of death or reinfarction (OR5.11, 95%CI2.48-10.52), ST (OR7.74, 95%CI2.87-20.93), and any TLR (OR2.88, 95%CI1.17-7.06). Impaired LVEF (OR4.77, 95%CI2.10-10.82), final TIMI flow 0-2 (OR1.93, 95%CI1.05-3.54), hypertension (OR1.69, 95%CI1.11-2.59), age (OR1.68, 95%CI1.41-2.01), and peak CK (OR1.25, 95%CI1.02-1.54) were independent predictors of death or reinfarction. Allocation to treatment with DES was an independent predictor of a lower risk of ST (OR0.35, 95%CI0.16-0.74) and any TLR (OR0.34, 95%CI0.21-0.54).

Conclusions: Killip class remains the strongest predictor of death or reinfarction among STEMI patients undergoing primary PCI. Noteworthy, DES use independently predicts a lower risk of TLR and definite ST.
Original languageEnglish
Pages (from-to)B70-B70
JournalJournal of the American College of Cardiology
Volume62
Issue number18, Suppl. 1
DOIs
Publication statusPublished - 2013
Event25th Annual Scientific Symposium of Transcatheter Cardiovascular Therapeutics, TCT 2013 - San Francisco, United States
Duration: 27 Oct 20131 Nov 2013
Conference number: 25

Keywords

  • METIS-302488
  • IR-89483

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