title: Predictors of in-hospital outcome after primary percutaneous coronary intervention for recurrent myocardial infarction.
abstract: BACKGROUND
  Recurrent acute myocardial infarction (AMI) is a deteriorated condition with high in-hospital morbidity and mortality, but the predictors of in-hospital outcome after primary percutaneous coronary intervention (PCI) for repeat AMI remain unclear.
  
  
  RESULTS
  Using the AMI-Kyoto Multi-Center Risk Study database, clinical background, angiographic findings, results of primary PCI, and in-hospital prognosis were retrospectively compared between primary PCI-treated AMI patients with previous myocardial infarction (MI) (repeat-MI patients, n=235) and those without previous MI (first-MI patients, n=1,550). The repeat-MI patients had higher prevalence of Killip class>or=3 at admission, larger number of diseased vessels, and a significantly higher in-hospital mortality rate than the first-MI patients. On multivariate analysis, number of diseased vessels>or=2 or diseased left main trunk (LMT) on initial coronary angiography was the independent positive predictor of in-hospital mortality in the repeat-MI patients, not in the first-MI patients, whereas acquisition of Thrombolysis In Myocardial Infarction 3 flow in the infarct-related artery immediately after primary PCI and elapsed time<24 h were the negative predictors in the first-MI patients, not in the repeat-MI patients.
  
  
  CONCLUSIONS
  Number of diseased vessels>or=2 or diseased LMT on initial coronary angiography is an independent risk factor of in-hospital death in recurrent-AMI patients undergoing primary PCI.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, and Department of Cardiology and Vascular Regenerative Medicine, Kyhoto Prefectural University School of Medicine, Kyoto, Japan. sjun@msj.biglobe.ne.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kohno
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sawada
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Takeda
authors.forename: Masayasu
authors.initials: M
authors.lastname: Arihara
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hyogo
authors.forename: Takakazu
authors.initials: T
authors.lastname: Yagi
authors.forename: Takatomo
authors.initials: T
authors.lastname: Shima
authors.forename: Takashi
authors.initials: T
authors.lastname: Okada
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Satoaki
authors.initials: S
authors.lastname: Matoba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shirayama
authors.forename: Makoto
authors.initials: M
authors.lastname: Kitamura
authors.forename: Keizo
authors.initials: K
authors.lastname: Furukawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D003326:Coronary Circulation; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome