title: Incidence and predictors of side-branch compromise in primary percutaneous coronary intervention for acute myocardial infarction.
abstract: OBJECTIVE
  We aimed to determine the incidence and predictors of side-branch compromise (SBC) in patients who underwent primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI).
  
  
  BACKGROUND
  Little data exist on SBC in AMI patients, especially in the drug-eluting stent era.
  
  
  METHODS
  We recruited 174 patients who underwent primary PCI over a 12-month period. After reviewing their coronary angiograms, we included for analysis 102 patients with a side branch >2 mm arising from the culprit lesion and that was spanned by a coronary stent. SBC was defined as post-stent implantation TIMI flow of <3 in the side branch.
  
  
  RESULTS
  Among the 102 patients analyzed, drug-eluting stents (n = 77), bare-metal stents (n = 17), and bioresorbable vascular scaffolds (n = 8) were used to treat the culprit lesions. Final TIMI flow of the main vessel was 2 or 3 in 101 patients (99%). SBC occurred in 23 patients (final side branch TIMI flow 0, n = 6; TIMI 1, n = 4; TIMI 2, n = 13), giving an incidence of 22.5%. Multivariate analysis showed non-left anterior descending (LAD) culprit vessel (odds ratio [OR], 3.66; 95% confidence interval [CI], 1.22-10.95; P=.02), higher peak creatine kinase level (OR, 1.03 for every 100-unit increase; 95% CI, 1.01-1.05; P=.01), and Rentrop score of 2/3 (OR, 3.57; 95% CI, 0.98-13.04; P=.055) to be independent predictors of SBC.
  
  
  CONCLUSIONS
  The incidence of SBC was 22.5%. The independent predictors of SBC were non-LAD culprit vessel, larger infarct size, and good collateral vessel formation.
authors.affiliation: National University Hospital Cardiac Department, Level 3, Main Building, National University Hospital, 5, Lower Kent Ridge Road, Singapore. leerch@hotmail.com.
authors.forename: Valerie
authors.initials: V
authors.lastname: Khoo
authors.forename: Liang
authors.initials: L
authors.lastname: Shen
authors.forename: Vanessa
authors.initials: V
authors.lastname: Khoo
authors.forename: Germaine
authors.initials: G
authors.lastname: Loo
authors.forename: Mark
authors.initials: M
authors.lastname: Richards
authors.forename: Tiong-Cheng
authors.initials: TC
authors.lastname: Yeo
authors.forename: Chi-Hang
authors.initials: CH
authors.lastname: Lee
mesh_terms: D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000196:embryology* / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015607:Stents
chemical_list: D003402:Creatine Kinase