Association of left ventricular end-diastolic pressure with mortality in patients undergoing percutaneous coronary intervention for acute coronary syndromes.
Catheter Cardiovasc Interv
; 96(4): E439-E446, 2020 10 01.
Article
em En
| MEDLINE
| ID: mdl-32141669
ABSTRACT
OBJECTIVES:
This study sought to investigate the relation between left ventricular end-diastolic pressure (LVEDP) and outcomes in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS).BACKGROUND:
Risk stratification in ACS patients is important. Data on the role of LVEDP in the prognostication of ACS patients are scarce.METHODS:
A total of 1,410 patients undergoing PCI for ACS and with available data on LVEDP were divided according to LVEDP tertiles (lowest tertile ≤13 mmHg, intermediate tertile 14-20 mmHg, and highest tertile >20 mmHg). The primary endpoint was all-cause mortality at a median follow-up of 246 [28-848] days.RESULTS:
Median LVEDP was 16 (11-22) mmHg. All-cause mortality was 2.8%, 4.5%, and 15.0% in the lowest, the intermediate, and the highest LVEDP tertile groups (p < .001), respectively. Belonging to the highest LVEDP tertile was associated with an increased risk of all-cause mortality (adjusted hazard ratio [HR] = 2.66, 95% confidence interval [CI] [1.30, 5.47], p = .008). By receiver operating characteristic curve analysis, the optimal cut-off value for predicting all-cause mortality was 20 mmHg (sensitivity 68.3%, specificity 72.5%). There was no differential effect of LVEDP on mortality in patients with and without LV dysfunction (interaction p = .23) or ST-elevation myocardial infarction as index ACS event (interaction p = .86).CONCLUSIONS:
In patients undergoing PCI for ACS, LVEDP was independently related with mortality. Hence, LVEDP should be incorporated into early risk stratification and clinical decision making of ACS patients.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Função Ventricular Esquerda
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Pressão Ventricular
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Síndrome Coronariana Aguda
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Intervenção Coronária Percutânea
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Infarto do Miocárdio sem Supradesnível do Segmento ST
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Infarto do Miocárdio com Supradesnível do Segmento ST
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article