MedStar Authors catalog › Details for: Clinical predictors for failure of percutaneous coronary intervention in ST-elevation myocardial infarction.
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Clinical predictors for failure of percutaneous coronary intervention in ST-elevation myocardial infarction.

by Barbash, Israel M; Ben-Dor, Itsik; Torguson, Rebecca; Maluenda, Gabriel; Xue, Zhenyi; Gaglia, Michael AJ; Sardi, Gabriel L; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron.
Citation: Journal of Interventional Cardiology. 25(2):111-7, 2012 Apr..Journal: Journal of interventional cardiology.ISSN: 0896-4327.Full author list: Barbash IM; Ben-Dor I; Torguson R; Maluenda G; Xue Z; Gaglia MA Jr; Sardi G; Satler LF; Pichard AD; Waksman R.UI/PMID: 22372924.Subject(s): Adult | Aged | Aged, 80 and over | Angioplasty, Balloon, Coronary | Female | Hospital Mortality | Humans | Logistic Models | Male | Middle Aged | *Myocardial Infarction/th [Therapy] | Risk Factors | Treatment FailureInstitution(s): MedStar Heart & Vascular Institute | MedStar Health Research InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1111/j.1540-8183.2011.00707.x (Click here) Abbreviated citation: J. INTERVENT. CARDIOL.. 25(2):111-7, 2012 Apr.Abstract: BACKGROUND: Failed percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is associated with adverse outcome. With recent improvements in PCI techniques, the incidence and predictors for failed primary PCI are unclear.Abstract: METHODS: A clinical database of consecutive patients who underwent primary or rescue PCI from 1993 to 2011 was used to compare patients with successful versus failed PCI. Clinical follow-up was obtained in-hospital, at 30 days and at 1 year.Abstract: RESULTS: Of 2900 patients fulfilling our inclusion criteria, 111 (3.98%) had failed PCI. Patients who had failed PCI were older (65 vs. 61 years), were more likely to be women (46% vs. 32%), were more likely to have previous peripheral vascular disease (19% vs. 11%), previous PCI (29% vs. 20%), and were more likely to present with cardiogenic shock (25% vs. 11%) (all P < 0.05). Multivariable logistic regression analysis identified female gender (OR 1.54; 95% CI 1.01-2.38), cardiogenic shock (2.07; 1.22-3.49), previous PCI (1.71; 1.08-2.70), and type C lesion (2.47; 1.60-3.82) as independent predictors of PCI failure. The in-hospital (18% vs. 4%) and long-term mortality (48% vs. 14%) were worse in the failed PCI group compared to the successful group (P < 0.05).Abstract: CONCLUSION: In patients with STEMI, primary PCI failure is uncommon. It is associated with worse short- and long-term clinical outcome compared with a successful procedure. Special care should be taken when PCI is performed in women at higher risk for failure when presenting with STEMI. 2012, Wiley Periodicals, Inc.

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