RT Journal Article
SR Electronic
T1 Late reopening of an occluded infarct related artery improves left ventricular function and long term clinical outcome
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 646
OP 651
DO 10.1136/hrt.2004.041152
VO 91
IS 5
A1 F Piscione
A1 G Galasso
A1 G De Luca
A1 G Marrazzo
A1 G Sarno
A1 O Viola
A1 D Accardo
A1 M Chiariello
YR 2005
UL http://heart.bmj.com/content/91/5/646.abstract
AB Objective: To assess effects on left ventricular (LV) function and on long term clinical outcome of late percutaneous transluminal coronary angioplasty (PTCA) of a chronically occluded infarct related artery. Methods: 65 patients who underwent PTCA a mean (SD) of 6.0 (1.2) months after a previous myocardial infarction were divided in two groups according to dilated artery patency status after PTCA: group 1 (35 patients with TIMI (thrombolysis in myocardial infarction) grade 3 flow) and group 2 (30 patients with TIMI grade 0–2 flow). Echocardiography was performed at admission and at six months’ follow up. A three year follow up was conducted with major adverse cardiac events (MACE) as end points. Results: At follow up, group 1 had improved global LV ejection fraction (48.7% v 43.6%, p < 0.001) and LV indexed end diastolic and end systolic volumes (75 v 86 ml/m2 and 40 v 53 ml/m2, respectively, p  =  0.011) compared with group 2. Kaplan-Meier analysis showed a higher incidence of cardiac death (p  =  0.02) and MACE (p < 0.0001) in group 2. TIMI 3 after PTCA was an independent predictor of event-free survival at follow up. Conclusion: Late PTCA of a chronically occluded infarct related artery improves LV function, reduces cardiac death, and improves long term clinical outcome.