title: Predictors of in-hospital prognosis after primary percutaneous coronary intervention for acute myocardial infarction requiring mechanical support devices.
abstract: BACKGROUND
  Predictors of in-hospital outcome after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) requiring mechanical support devices such as intra-aortic balloon pumping (IABP) and/or percutaneous cardiopulmonary support (PCPS) 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 requiring mechanical assist devices (with-IABP/PCPS patients, n=275) and those without (without-IABP/PCPS patients, n=1,510). The with-IABP/PCPS patients were more likely to have a larger number of diseased vessels, lower Thrombolysis In Myocardial Infarction (TIMI) grade in the infarct-related artery (IRA) before/after primary PCI, and a significantly higher in-hospital mortality rate than the without-IABP/PCPS patients. On multivariate analysis, the number of diseased vessels > or =2 or diseased left main trunk (LMT) at initial coronary angiography (CAG) was the independent positive predictor of the in-hospital mortality in the with-IABP/PCPS patients, not in the without-IABP/PCPS patients, whereas acquisition of TIMI 3 flow in the IRA immediately after primary PCI was the negative predictor in the without-IABP/PCPS patients, not in the with-IABP/PCPS patients.
  
  
  CONCLUSIONS
  The number of diseased vessels > or =2 or diseased LMT at initial CAG is an independent risk factor of in-hospital death in primary PCI-treated AMI patients requiring mechanical support devices.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital, 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: Masayoshi
authors.initials: M
authors.lastname: Kimura
authors.forename: Makoto
authors.initials: M
authors.lastname: Ariyoshi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsui
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: 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: Akiyoshi
authors.initials: A
authors.lastname: Matsumuro
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 / Q000379:methods*; D001243:Assisted Circulation / Q000379:methods* / Q000706:statistics & numerical data; D001808:Blood Vessels / Q000473:pathology; D017023:Coronary Angiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome