[Predictors of mortality following rescue percutaneous intervention].
OBJECTIVE
Rescue percutaneous transluminal coronary angioplasty (PTCA) is a mechanical reperfusion strategy aimed at achieving patency of the infarct-related artery after failed thrombolysis. However, in randomized studies the indication for rescue PTCA was per protocol rather than based on clinical criteria. The aim of this study was to determine predictors of mortality at 30 days following rescue percutaneous intervention.


METHODS
Seventy-one consecutive patients who underwent rescue PTCA were included. Mean age was 61 (11) years, 80% were men and 9.8% had diabetes.


RESULTS
The infarct-related artery was the left anterior descending artery in the 46.5%, and the mean percentage of stenoses was 91.0 (11.6)%. A stent was implanted in 97.2% and TIMI II-III flow was obtained in the 97.2% of the patients. Overall mortality was 9.8% at 30 days follow-up and 11.3% at 1 year follow-up. In the multivariate analysis, the independent predictors of mortality at 30 days were age (OR=1.2, 95% CI: 1.03-1.5, P=.001), Killip class III-IV (OR=20.1; 95% CI: 1.7-500; P=.003), PTCA failure (OR=indeterminate; P=.04) and left anterior descending artery involvement (OR=12.6; 95% CI: 0.7-214.9; P=.04).


CONCLUSIONS
Rescue PTCA is effective in restoring blood flow in the infarct-related artery in the majority of patients in whom thrombolysis failed. The independent predictors of mortality were similar to those previously reported in acute myocardial infarction.
Jiménez-Quevedo
Pilar
P
Instituto Cardiovascular, Servicio de Cardiología Intervencionista, Hospital Clínico San Carlos, Madrid, Spain.
Sabaté
Manel
M
Angiolillo
Dominick J
DJ
Hernández Antolín
Rosana
R
Fernández
Cristina
C
Corros
Cecilia
C
Alfonso
Fernando
F
Escaned
Javier
J
Bañuelos
Camino
C
Moreno
Raúl
R
Pérez-Vizcayno
María J
MJ
Macaya
Carlos
C
D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors