title: Late reopening of an occluded infarct related artery improves left ventricular function and long term clinical outcome.
abstract: OBJECTIVE
  To assess effects on left ventricular (LV) function and on long term clinical outcome of late percutaneous transluminal coronary angioplasty (PTCA) of a chronically occluded infarct related artery.
  
  
  METHODS
  65 patients who underwent PTCA a mean (SD) of 6.0 (1.2) months after a previous myocardial infarction were divided in two groups according to dilated artery patency status after PTCA: group 1 (35 patients with TIMI (thrombolysis in myocardial infarction) grade 3 flow) and group 2 (30 patients with TIMI grade 0-2 flow). Echocardiography was performed at admission and at six months' follow up. A three year follow up was conducted with major adverse cardiac events (MACE) as end points.
  
  
  RESULTS
  At follow up, group 1 had improved global LV ejection fraction (48.7% v 43.6%, p < 0.001) and LV indexed end diastolic and end systolic volumes (75 v 86 ml/m(2) and 40 v 53 ml/m(2), respectively, p = 0.011) compared with group 2. Kaplan-Meier analysis showed a higher incidence of cardiac death (p = 0.02) and MACE (p < 0.0001) in group 2. TIMI 3 after PTCA was an independent predictor of event-free survival at follow up.
  
  
  CONCLUSIONS
  Late PTCA of a chronically occluded infarct related artery improves LV function, reduces cardiac death, and improves long term clinical outcome.
authors.affiliation: Department of Cardiology, Federico II University, Naples, Italy. piscione@unina.it <piscione@unina.it>
authors.forename: F
authors.initials: F
authors.lastname: Piscione
authors.forename: G
authors.initials: G
authors.lastname: Galasso
authors.forename: G
authors.initials: G
authors.lastname: De Luca
authors.forename: G
authors.initials: G
authors.lastname: Marrazzo
authors.forename: G
authors.initials: G
authors.lastname: Sarno
authors.forename: O
authors.initials: O
authors.lastname: Viola
authors.forename: D
authors.initials: D
authors.lastname: Accardo
authors.forename: M
authors.initials: M
authors.lastname: Chiariello
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000401:mortality; D017023:Coronary Angiography / Q000379:methods; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D018572:Disease-Free Survival; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000517:prevention & control*