Objectives:Meta-analysis was performed to evaluate the effect of staged revascularization with concomitant chronic total occlusion(CTO)in the non-infarct-associated artery(non-IRA)in patients with ST-segment elevation...Objectives:Meta-analysis was performed to evaluate the effect of staged revascularization with concomitant chronic total occlusion(CTO)in the non-infarct-associated artery(non-IRA)in patients with ST-segment elevation myocardial infarction(STEMI)treated with primary percutaneous coronary intervention(p-PCI).Methods:Various electronic databases were searched for studies published from inception to June,2021.The primary endpoint was all-cause death,and the secondary endpoint was a composite of major adverse cardiac events(MACEs).Odds ratios(ORs)were pooled with 95%confidence intervals(CIs)for dichotomous data.Results:Seven studies involving 1540 participants were included in thefinal analysis.Pooled analyses revealed that patients with successful staged revascularization for CTO in non-IRA with STEMI treated with p-PCI had overall lower all-cause death compared with the occluded CTO group(OR,0.46;95%CI,0.23–0.95),cardiac death(OR,0.43;95%CI,0.20–0.91),MACEs(OR,0.47;95%CI,0.32–0.69)and heart failure(OR,0.57;95%CI,0.37–0.89)com-pared with the occluded CTO group.No significant differences were observed between groups regarding myocardial infarction and repeated revascularization.Conclusions:Successful revascularization of CTO in the non-IRA was associated with better outcomes in patients with STEMI treated with p-PCI.展开更多
Background The incremental predictive value of red cell distribution width(RDW)on Korea Acute Myocardial Infarction Registry(KAMIR)score in patients with ST segment elevation myocardial infarction(STEMI)has not been a...Background The incremental predictive value of red cell distribution width(RDW)on Korea Acute Myocardial Infarction Registry(KAMIR)score in patients with ST segment elevation myocardial infarction(STEMI)has not been assessed. This study was to investigate whether RDW had additional prognostic value on KAMIR score for predicting in-hospital death of STEMI patients. Methods Seven hundred and seven STEMI patients were included in this study. The predictive value was evaluated using the receiver operating characteristic(ROC). Multivariate logistic regression was used to determine risk predictors. Results Thirty four patients died while in hospital,who were older than those who survived,and had more proportion of Killip class ≥ 2 and no in-hospital PCI. Blood glucose,serum creatinine,white blood cell count,RDW and KAMIR score were significantly higher in the Death group,among whom systolic blood pressure,hemoglobin and LVEF were lower.ROC curve analysis showed RDW could predict in-hospital death,with the optimal cut-off values being 14.1%(AUC=0.707,95%CI,0.618-0.796,P<0.001). When compared with the KAMIR score alone,the addition of RDW was associated with significant improvements in predicting in-hospital(AUC:0.865 vs. 0.839,P=0.039).Conclusion RDW might provide additional information over the KAMIR score in STEMI patients.展开更多
基金supported by the Beijing Tsinghua Changgung Hospital Fund(grant No.12019C1009).
文摘Objectives:Meta-analysis was performed to evaluate the effect of staged revascularization with concomitant chronic total occlusion(CTO)in the non-infarct-associated artery(non-IRA)in patients with ST-segment elevation myocardial infarction(STEMI)treated with primary percutaneous coronary intervention(p-PCI).Methods:Various electronic databases were searched for studies published from inception to June,2021.The primary endpoint was all-cause death,and the secondary endpoint was a composite of major adverse cardiac events(MACEs).Odds ratios(ORs)were pooled with 95%confidence intervals(CIs)for dichotomous data.Results:Seven studies involving 1540 participants were included in thefinal analysis.Pooled analyses revealed that patients with successful staged revascularization for CTO in non-IRA with STEMI treated with p-PCI had overall lower all-cause death compared with the occluded CTO group(OR,0.46;95%CI,0.23–0.95),cardiac death(OR,0.43;95%CI,0.20–0.91),MACEs(OR,0.47;95%CI,0.32–0.69)and heart failure(OR,0.57;95%CI,0.37–0.89)com-pared with the occluded CTO group.No significant differences were observed between groups regarding myocardial infarction and repeated revascularization.Conclusions:Successful revascularization of CTO in the non-IRA was associated with better outcomes in patients with STEMI treated with p-PCI.
基金supported by Guangdong Provincial Department of Science and Technology(No:2015A020210061)
文摘Background The incremental predictive value of red cell distribution width(RDW)on Korea Acute Myocardial Infarction Registry(KAMIR)score in patients with ST segment elevation myocardial infarction(STEMI)has not been assessed. This study was to investigate whether RDW had additional prognostic value on KAMIR score for predicting in-hospital death of STEMI patients. Methods Seven hundred and seven STEMI patients were included in this study. The predictive value was evaluated using the receiver operating characteristic(ROC). Multivariate logistic regression was used to determine risk predictors. Results Thirty four patients died while in hospital,who were older than those who survived,and had more proportion of Killip class ≥ 2 and no in-hospital PCI. Blood glucose,serum creatinine,white blood cell count,RDW and KAMIR score were significantly higher in the Death group,among whom systolic blood pressure,hemoglobin and LVEF were lower.ROC curve analysis showed RDW could predict in-hospital death,with the optimal cut-off values being 14.1%(AUC=0.707,95%CI,0.618-0.796,P<0.001). When compared with the KAMIR score alone,the addition of RDW was associated with significant improvements in predicting in-hospital(AUC:0.865 vs. 0.839,P=0.039).Conclusion RDW might provide additional information over the KAMIR score in STEMI patients.
