Influence of previous myocardial infarction site on in-hospital outcome after primary percutaneous coronary intervention for repeat myocardial infarction.
BACKGROUND
Recurrent acute myocardial infarction (AMI) is a disastrous condition with high in-hospital morbidity and mortality. However, the relation between location of previous myocardial infarction (MI) and in-hospital outcome in repeat-AMI patients undergoing primary percutaneous coronary intervention (PCI) remains 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 anterior MI (anterior group, n=151) and those with previous non-anterior MI (non-anterior group, n=157). Clinical backgrounds, angiographic findings, results of primary PCI, and in-hospital outcome did not differ significantly between the two groups. On multivariate analysis, Killip class > or =3 at admission, number of diseased vessels > or =2 or diseased left main trunk at initial coronary angiography, and age were the independent predictors of in-hospital mortality in the recurrent-AMI patients, but not the anterior location of previous MI.


CONCLUSIONS
These results suggest that among recurrent-AMI patients undergoing primary PCI, in-hospital prognosis mostly depends on the severity of acute heart failure at the onset and the residual myocardial ischemia rather than previous MI sites.
Shiraishi
Jun
J
Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto 605-0981, Japan. sjun@msj.biglobe.ne.jp
Kohno
Yoshio
Y
Sawada
Takahisa
T
Takeda
Mitsuo
M
Arihara
Masayasu
M
Hyogo
Masayuki
M
Shima
Takatomo
T
Okada
Takashi
T
Nakamura
Takeshi
T
Matoba
Satoaki
S
Yamada
Hiroyuki
H
Matsumuro
Akiyoshi
A
Shirayama
Takeshi
T
Kitamura
Makoto
M
Furukawa
Keizo
K
Matsubara
Hiroaki
H
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D017023:Coronary Angiography; D004630:Emergencies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome