title: Long-term survival and functional outcome of unselected patients undergoing percutaneous coronary intervention for acute myocardial infarction.
abstract: BACKGROUND
  Percutaneous coronary intervention (PCI) is the most effective reperfusion modality in patients with acute myocardial infarction (MI). Data concerning long-term survival and functional outcome are sparse.
  
  
  METHODS
  One thousand consecutive patients treated by emergency PCI were systematically ana-lysed in a single-centre registry. Multivariate predictors of in-hospital mortality, post-discharge mortality and late functional capacity were identified.
  
  
  RESULTS
  Follow-up was completed for 978 patients. The median clinical follow-up length was 3.2 years. In-hospital and post-discharge mortality were 7.6% and 7.3%, respectively. Annualised post-discharge mortality remained stable over time at 2% per year. Independent predictors of in-hospital death were cardiogenic shock, TIMI flow <3 after PCI, left ventricular ejection fraction <40%, age and time to patent artery >6 h. Independent predictors of post-discharge mortality were TIMI flow after PCI <3, prior MI, elevated glucose levels at admission, and increasing age. In contrast, cardiogenic shock, time to patent artery and left ventricular ejection fraction <40% were not independently associated with post-hospital death. At late follow-up, 47% of patients had normal functional capacity and 49.1% were in New York Heart Association functional class II. Predictors of impaired functional capacity at follow-up were age, gender, smoking habits and multivessel coronary disease.
  
  
  CONCLUSIONS
  Post-discharge mortality after PCI for acute MI was 2% per year. Significant differences exist between predictors of in-hospital and post-discharge mortality. The functional capacity of surviving patients was remarkably good, even when presented in cardiogenic shock.
authors: Division of Cardiology, Department of Internal Medicine, Triemli Hospital, Zurich, Switzerland. pablo.anabitarte@ksa.ch
authors: Pablo
authors: P
authors: Anabitarte
authors: David J
authors: DJ
authors: Kurz
authors: Irene
authors: I
authors: Stettler
authors: Barbara
authors: B
authors: Naegeli
authors: Osmund
authors: O
authors: Bertel
authors: Juergen
authors: J
authors: Frielingsdorf
authors: Dominik
authors: D
authors: Maurer
authors: Edwin
authors: E
authors: Straumann
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D004638:Emergency Treatment; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D010351:Patient Discharge; D011446:Prospective Studies; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome