Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials

Aims: The aim of this study was to identify predictors of adverse events among patients with ST-elevation myocardial infarction (STEMI) undergoing contemporary primary percutaneous coronary intervention (PCI). Methods and results: Individual data of 2,655 patients from two primary PCI trials (EXAMIN...

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Autores: Taniwaki, M, Stefanini, GG, Raber, L, Brugaletta, S, Cequier, A, Heg, D, Iniguez, A, Kelbaek, H, Serra, A, Ostoijic, M, Hernandez-Antolin, R, Baumbach, A, Blochlinger, S, Juni, P, Mainar, V, Sabate, M, Windecker, S
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p8447
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8447
https://boris.unibe.ch/id/eprint/57576
Access Level:acceso abierto
Palabra clave:drug-eluting stent
percutaneous coronary intervention
primary angioplasty
ST-segment elevation myocardial infarction
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spelling Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trialsTaniwaki, MStefanini, GGRaber, LBrugaletta, SCequier, AHeg, DIniguez, AKelbaek, HSerra, AOstoijic, MHernandez-Antolin, RBaumbach, ABlochlinger, SJuni, PMainar, VSabate, MWindecker, Sdrug-eluting stentpercutaneous coronary interventionprimary angioplastyST-segment elevation myocardial infarctionAims: The aim of this study was to identify predictors of adverse events among patients with ST-elevation myocardial infarction (STEMI) undergoing contemporary primary percutaneous coronary intervention (PCI). Methods and results: Individual data of 2,655 patients from two primary PCI trials (EXAMINATION, N=1,504; COMFORTABLE AMI, N=1,161) with identical endpoint defmitions and event adjudication were pooled. Predictors of all-cause death or any reinfarction and definite stent thrombosis (ST) and target lesion revascularisation (TLR) outcomes at one year were identified by multivariable Cox regression analysis. Killip class III or IV was the strongest predictor of all-cause death or any reinfarction (OR 5.11, 95% CI: 2.48-10.52), definite ST (OR 7.74, 95% CI: 2.87-20.93), and TLR (OR 2.88, 95% CI: 1.17-7.06). Impaired left ventricular ejection fraction (OR 4.77, 95% CI: 2.10-10.82), final TIMI flow 0-2 (OR 1.93, 95% CI: 1.053.54), arterial hypertension (OR 1.69, 95% CI: 1.11-2.59), age (OR 1.68, 95% CI: 1.41-2.01), and peak CK (OR 1.25, 95% CI: 1.02-1.54) were independent predictors of all-cause death or any reinfarction. Allocation to treatment with DES was an independent predictor of a lower risk of definite ST (OR 0.35, 95% CI: 0.160.74) and any TLR (OR 0.34, 95% CI: 0.21-0.54). Conclusions: Killip class remains the strongest predictor of all-cause death or any reinfarction among STEMI patients undergoing primary PCI. DES use independently predicts a lower risk of TLR and definite ST compared with BMS. The COMFORTABLE AMI trial is registered at: http://www.clinicaltrials.gov/ ct2/show/NCT00962416. The EXAMINATION trial is registered at: http://www.clinicaltrials.govict2/show/ NCT00828087EUROPA EDITION2015info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8447https://boris.unibe.ch/id/eprint/57576EuroInterventionISSN: 1774024XISSNe: 19696213reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p84472026-06-14T12:41:47Z
dc.title.none.fl_str_mv Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials
title Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials
spellingShingle Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials
Taniwaki, M
drug-eluting stent
percutaneous coronary intervention
primary angioplasty
ST-segment elevation myocardial infarction
title_short Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials
title_full Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials
title_fullStr Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials
title_full_unstemmed Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials
title_sort Predictors of adverse events among patients undergoing primary percutaneous coronary intervention: insights from a pooled analysis of the COMFORTABLE AN and EX AMIfATHON trials
dc.creator.none.fl_str_mv Taniwaki, M
Stefanini, GG
Raber, L
Brugaletta, S
Cequier, A
Heg, D
Iniguez, A
Kelbaek, H
Serra, A
Ostoijic, M
Hernandez-Antolin, R
Baumbach, A
Blochlinger, S
Juni, P
Mainar, V
Sabate, M
Windecker, S
author Taniwaki, M
author_facet Taniwaki, M
Stefanini, GG
Raber, L
Brugaletta, S
Cequier, A
Heg, D
Iniguez, A
Kelbaek, H
Serra, A
Ostoijic, M
Hernandez-Antolin, R
Baumbach, A
Blochlinger, S
Juni, P
Mainar, V
Sabate, M
Windecker, S
author_role author
author2 Stefanini, GG
Raber, L
Brugaletta, S
Cequier, A
Heg, D
Iniguez, A
Kelbaek, H
Serra, A
Ostoijic, M
Hernandez-Antolin, R
Baumbach, A
Blochlinger, S
Juni, P
Mainar, V
Sabate, M
Windecker, S
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv drug-eluting stent
percutaneous coronary intervention
primary angioplasty
ST-segment elevation myocardial infarction
topic drug-eluting stent
percutaneous coronary intervention
primary angioplasty
ST-segment elevation myocardial infarction
description Aims: The aim of this study was to identify predictors of adverse events among patients with ST-elevation myocardial infarction (STEMI) undergoing contemporary primary percutaneous coronary intervention (PCI). Methods and results: Individual data of 2,655 patients from two primary PCI trials (EXAMINATION, N=1,504; COMFORTABLE AMI, N=1,161) with identical endpoint defmitions and event adjudication were pooled. Predictors of all-cause death or any reinfarction and definite stent thrombosis (ST) and target lesion revascularisation (TLR) outcomes at one year were identified by multivariable Cox regression analysis. Killip class III or IV was the strongest predictor of all-cause death or any reinfarction (OR 5.11, 95% CI: 2.48-10.52), definite ST (OR 7.74, 95% CI: 2.87-20.93), and TLR (OR 2.88, 95% CI: 1.17-7.06). Impaired left ventricular ejection fraction (OR 4.77, 95% CI: 2.10-10.82), final TIMI flow 0-2 (OR 1.93, 95% CI: 1.053.54), arterial hypertension (OR 1.69, 95% CI: 1.11-2.59), age (OR 1.68, 95% CI: 1.41-2.01), and peak CK (OR 1.25, 95% CI: 1.02-1.54) were independent predictors of all-cause death or any reinfarction. Allocation to treatment with DES was an independent predictor of a lower risk of definite ST (OR 0.35, 95% CI: 0.160.74) and any TLR (OR 0.34, 95% CI: 0.21-0.54). Conclusions: Killip class remains the strongest predictor of all-cause death or any reinfarction among STEMI patients undergoing primary PCI. DES use independently predicts a lower risk of TLR and definite ST compared with BMS. The COMFORTABLE AMI trial is registered at: http://www.clinicaltrials.gov/ ct2/show/NCT00962416. The EXAMINATION trial is registered at: http://www.clinicaltrials.govict2/show/ NCT00828087
publishDate 2015
dc.date.none.fl_str_mv 2015
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8447
https://boris.unibe.ch/id/eprint/57576
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8447
https://boris.unibe.ch/id/eprint/57576
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv EUROPA EDITION
publisher.none.fl_str_mv EUROPA EDITION
dc.source.none.fl_str_mv EuroIntervention
ISSN: 1774024X
ISSNe: 19696213
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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