title: Comparison of prognostic outcome between left circumflex artery-related and right coronary artery-related acute inferior wall myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: BACKGROUND
  This study evaluated the 30-day clinical outcome of patients with acute inferior wall ST-elevation myocardial infarction (AIW-STEMI) from occlusion of the left circumflex artery (LCX) vs the right coronary artery (RCA) undergoing primary percutaneous coronary intervention (PCI).
  
  
  OBJECTIVE
  The clinical outcomes of AIW-STEMI caused by RCA and LCX occlusion may be different for patients undergoing primary PCI.
  
  
  METHODS
  Between May 2002 and September 2009, 646 consecutive patients with AIW-STEMI undergoing primary PCI were enrolled. Of these patients, 520 (80.5%) with AIW-STEMI caused by RCA occlusion were categorized into group 1, whereas the remaining 126 (19.5%) whose AIW-STEMI was caused by LCX occlusion served as group 2.
  
  
  RESULTS
  The results demonstrated that the frequency of advanced congestive heart failure, respiratory failure requiring mechanical ventilatory support, and 30-day mortality were remarkably higher in group 2 than in group 1 (all P < 0.01). Conversely, the incidence of right ventricular infarction and complete heart block were notably higher in group 1 than in group 2 (all P < 0.001). Additionally, the peak level of creatine kinase-isoenzyme MB was significantly higher, whereas the left ventricular ejection fraction was notably lower in group 2 than in group 1. Multivariate analysis demonstrated that advanced CHF, high serum creatinine level, low systolic blood pressure, low left ventricular ejection fraction, and LCX as the infarct-related artery were significantly and independently predictive of 30-day mortality (all P < 0.05).
  
  
  CONCLUSIONS
  The 30-day prognostic outcome was less favorable in LCX-related AIW-STEMI compared with RCA-related AIW-STEMI undergoing primary PCI.
authors: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan, Republic of China.
authors: Yung-Lung
authors: YL
authors: Chen
authors: Chi-Ling
authors: CL
authors: Hang
authors: Hsiu-Yu
authors: HY
authors: Fang
authors: Tzu-Hsien
authors: TH
authors: Tsai
authors: Cheuk-Kwan
authors: CK
authors: Sun
authors: Chien-Jen
authors: CJ
authors: Chen
authors: Shyh-Ming
authors: SM
authors: Chen
authors: Cheng-Hsu
authors: CH
authors: Yang
authors: Yuan-Kai
authors: YK
authors: Hsieh
authors: Chiung-Jen
authors: CJ
authors: Wu
authors: Morgan
authors: M
authors: Fu
authors: Hon-Kan
authors: HK
authors: Yip
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D054059:Coronary Occlusion / Q000097:blood / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006327:Heart Block / Q000209:etiology; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D052279:Creatine Kinase, MB Form