Abstract:
AIMS:Prognostic importance of coronary vessel dominance in patients with ST-elevation myocardial infarction (STEMI) remains uncertain. The aim of this study was to assess influence of coronary vessel dominance on the short- and long-term outcome after STEMI. METHODS AND RESULTS:Coronary angiographic images of consecutive patients presenting with first STEMI were retrospectively reviewed to assess coronary vessel dominance. Patients were followed after STEMI during a median period of 48 (IQR38-61) months for the occurrence of all-cause mortality and the composite of reinfarction and cardiac death. The population comprised 1131 patients of which 971 (86%) patients had a right dominant, 102 (9%) a left dominant, and 58 (5%) a balanced system. After 5 years of follow-up, the cumulative incidence of all-cause mortality was significantly higher in patients with a left dominant system, compared with a right dominant and balanced system (log-rank P = 0.013). Moreover, a left dominant system was an independent predictor for 30-day mortality (OR 2.51, 95% CI 1.11-5.67, P = 0.027) and the composite of reinfarction and cardiac death within 30-days after STEMI (OR 2.25, 95% CI 1.09-4.61, P = 0.028). In patients surviving first 30-days post-STEMI, coronary vessel dominance had no influence on long-term outcome. CONCLUSIONS:A left dominant coronary artery system is associated with a significantly increased risk of 30-day mortality and early reinfarction after STEMI. After surviving the first 30-days post-STEMI, coronary vessel dominance had no influence on long-term outcome.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Veltman CE,van der Hoeven BL,Hoogslag GE,Boden H,Kharbanda RK,de Graaf MA,Delgado V,van Zwet EW,Schalij MJ,Bax JJ,Scholte AJdoi
10.1093/eurheartj/ehu236subject
Has Abstractpub_date
2015-05-01 00:00:00pages
1023-30issue
17eissn
0195-668Xissn
1522-9645pii
ehu236journal_volume
36pub_type
杂志文章abstract::Nitrates and beta-blockers have been the mainstay in the therapy of chronic stable angina pectoris for many years. Since an important number of patients remains symptomatic, new potent anti-ischemic agents like the calcium antagonists fulfil a great clinical need. Combined therapy with beta-blockers and calcium antago...
journal_title:European heart journal
pub_type: 杂志文章,评审
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abstract:AIMS:Drug-eluting stents (DES) represent a major advance in interventional cardiology. Along with the success shown, current DES also present limitations related to the presence of polymer-coating, fixed drug, and dose used. With the ISAR (Individualized Drug-Eluting Stent System to Abrogate Restenosis) project, a DES ...
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pub_type: 临床试验,杂志文章
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2003-01-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1990-02-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
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更新日期:1999-03-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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