Influence of previous myocardial infarction site on in-hospital outcome after primary percutaneous coronary intervention for repeat myocardial infarction

• Published in: Journal of cardiology 2010-01, Vol.55 (1), p.77-83
• Main Authors: Shiraishi, Jun, MD, Kohno, Yoshio, MD, Sawada, Takahisa, MD, FJCC, Takeda, Mitsuo, MD, Arihara, Masayasu, MD, Hyogo, Masayuki, MD, Shima, Takatomo, MD, Okada, Takashi, MD, Nakamura, Takeshi, MD, Matoba, Satoaki, MD, Yamada, Hiroyuki, MD, Matsumuro, Akiyoshi, MD, Shirayama, Takeshi, MD, Kitamura, Makoto, MD, Furukawa, Keizo, MD, FJCC, Matsubara, Hiroaki, MD
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty, Balloon, Coronary - mortality; Cardiovascular; Coronary Angiography; Emergencies; Female; Hospital Mortality; Humans; Male; Myocardial Infarction - mortality; Myocardial Infarction - pathology; Myocardial Infarction - therapy; Primary percutaneous coronary intervention; Prognosis; Recurrence; Recurrent myocardial infarction; Retrospective Studies; Treatment Outcome
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2009.09.001

Summary Background Recurrent acute myocardial infarction (AMI) is a disastrous condition with high in-hospital morbidity and mortality. However, the relation between location of previous myocardial infarction (MI) and in-hospital outcome in repeat-AMI patients undergoing primary percutaneous coronary intervention (PCI) remains unclear. Methods and results Using the AMI-Kyoto Multi-Center Risk Study database, clinical background, angiographic findings, results of primary PCI, and in-hospital prognosis were retrospectively compared between primary PCI-treated AMI patients with previous anterior MI (anterior group, n = 151) and those with previous non-anterior MI (non-anterior group, n = 157). Clinical backgrounds, angiographic findings, results of primary PCI, and in-hospital outcome did not differ significantly between the two groups. On multivariate analysis, Killip class ≥3 at admission, number of diseased vessels ≥2 or diseased left main trunk at initial coronary angiography, and age were the independent predictors of in-hospital mortality in the recurrent-AMI patients, but not the anterior location of previous MI. Conclusions These results suggest that among recurrent-AMI patients undergoing primary PCI, in-hospital prognosis mostly depends on the severity of acute heart failure at the onset and the residual myocardial ischemia rather than previous MI sites.