PMID- 16644856
OWN - NLM
STAT- MEDLINE
DCOM- 20061219
LR  - 20211020
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 92
IP  - 12
DP  - 2006 Dec
TI  - Long-term impact of multivessel disease on cause-specific mortality after ST 
      elevation myocardial infarction treated with reperfusion therapy.
PG  - 1760-3
AB  - OBJECTIVES: To investigate the long-term impact of multivessel coronary artery 
      disease (MVD) on cause-specific mortality in patients with ST elevation 
      myocardial infarction (STEMI) treated with reperfusion therapy. METHODS AND 
      RESULTS: Patients with STEMI (n = 395) treated with primary angioplasty or 
      thrombolysis in the setting of a randomised clinical trial were enrolled in the 
      study. Follow up was 8 (2) years. For patients who died all available records 
      were reviewed to assess the specific cause of death. MVD was present in 57% of 
      patients. Patients with MVD were older and more of them had diabetes and previous 
      myocardial infarction. Compared with the non-MVD group, residual left ventricular 
      ejection fraction was lower (45.9% v 49.6%, p = 0.001) and total mortality was 
      higher in patients with MVD (32% v 19%, p = 0.002). After adjustment for 
      potential confounders this association was not significant (hazard ratio 1.4, 95% 
      confidence interval (CI) 0.9 to 2.2). When the specific cause of death was 
      considered, sudden death was comparable between patients with and without MVD 
      (10% v 8%, p = 0.49) but death caused by heart failure was significantly higher 
      in patients with MVD (hazard ratio 7.4, 95% CI 1.7 to 32.2). CONCLUSION: Patients 
      with STEMI and MVD have a higher long-term mortality than do patients with 
      non-MVD. MVD is not an independent predictor of long-term total mortality or 
      sudden death. However, MVD is a very strong and independent predictor of 
      long-term death caused by heart failure.
FAU - van der Schaaf, R J
AU  - van der Schaaf RJ
AD  - Department of Cardiology, Isala klinieken, locatie Weezenlanden, Zwolle, The 
      Netherlands.
FAU - Timmer, J R
AU  - Timmer JR
FAU - Ottervanger, J P
AU  - Ottervanger JP
FAU - Hoorntje, J C A
AU  - Hoorntje JC
FAU - de Boer, M-J
AU  - de Boer MJ
FAU - Suryapranata, H
AU  - Suryapranata H
FAU - Zijlstra, F
AU  - Zijlstra F
FAU - Dambrink, J-H E
AU  - Dambrink JH
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20060427
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Female
MH  - Heart Failure/etiology/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/mortality/*therapy
MH  - Myocardial Reperfusion/*methods
MH  - Thrombolytic Therapy/methods
MH  - Ventricular Dysfunction, Left/etiology/mortality/therapy
PMC - PMC1861301
COIS- Competing interests: None declared.
EDAT- 2006/04/29 09:00
MHDA- 2006/12/21 09:00
PMCR- 2009/12/01
CRDT- 2006/04/29 09:00
PHST- 2006/04/29 09:00 [pubmed]
PHST- 2006/12/21 09:00 [medline]
PHST- 2006/04/29 09:00 [entrez]
PHST- 2009/12/01 00:00 [pmc-release]
AID - hrt.2005.086058 [pii]
AID - ht86058 [pii]
AID - 10.1136/hrt.2005.086058 [doi]
PST - ppublish
SO  - Heart. 2006 Dec;92(12):1760-3. doi: 10.1136/hrt.2005.086058. Epub 2006 Apr 27.