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Clinical outcomes in myocardial infarction and multivessel disease after a cardiac rehabilitation programme: Partial versus complete revascularization.
Mori Junco, Ricardo; Dalmau Gonzalez-Gallarza, Regina; Castro Conde, Almudena; González Fernandez, Oscar; Álvarez Ortega, Carlos; Blázquez Bermejo, Zorba; Furuya-Kanamori, Luis; Moreno Gomez, Raúl; López de Sa Arreses, Esteban.
Affiliation
  • Mori Junco R; Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
  • Dalmau Gonzalez-Gallarza R; Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain; Unidad de Rehabilitación Cardiaca, Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain. Electronic address: reginadalmau71@gmail.com.
  • Castro Conde A; Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain; Unidad de Rehabilitación Cardiaca, Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
  • González Fernandez O; Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
  • Álvarez Ortega C; Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
  • Blázquez Bermejo Z; Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
  • Furuya-Kanamori L; Research School of Population Health, The Australian National University, Canberra, Australia.
  • Moreno Gomez R; Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain; Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universidario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
  • López de Sa Arreses E; Servicio de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain; Unidad de Cuidados Agudos Cardiologícos, Servico de Cardiología, Hospital Universitario La Paz, 261, Paseo de la Castellana, 28046 Madrid, Spain.
Arch Cardiovasc Dis ; 110(4): 234-241, 2017 Apr.
Article in En | MEDLINE | ID: mdl-28082243
ABSTRACT

BACKGROUND:

Current guideline recommendations encourage culprit vessel only percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease. However, recent studies have shown a better clinical outcome in patients who receive multivessel PCI.

AIM:

To measure and compare clinical outcomes between partial revascularization (PR) versus complete revascularization (CR) in patients with STEMI and multivessel disease who underwent a cardiac rehabilitation programme.

METHODS:

We retrospectively reviewed the medical records of 282 patients with STEMI and multivessel disease who received PR or CR and were subsequently enrolled in a cardiac rehabilitation programme between July 2006 and November 2013 at La Paz University Hospital. The incidences of cardiovascular events, new PCI, hospital admissions for cardiovascular reasons and mortality were compared between the PR and CR groups.

RESULTS:

Overall, 143 patients received PR and 139 received CR. Baseline characteristics were similar in both groups, except for mean age (59.3 vs. 56.7 years; P=0.02), diabetes mellitus prevalence (34.3% vs. 20.1%; P=0.01) and number of arteries with stenosis (2.6 vs. 2.3; P=0.001). During the mean follow-up of 48.0±25.9 months, a cardiovascular event occurred in 23 (16.1%) PR patients and 20 (14.4%) CR patients, with no statistically significant differences in the early (hazard ratio 0.61, 95% confidence interval 0.19-1.89) or late (hazard ratio 1.40, 95% confidence interval 0.62-3.14) follow-up periods. Cox regression, adjusted for age, sex, presence of diabetes mellitus and number of affected coronary vessels, showed no difference in new cardiovascular event risk.

CONCLUSIONS:

There were no statistical differences in clinical outcomes between PR and CR among patients who received cardiac rehabilitation.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Coronary Artery Disease / Coronary Stenosis / Percutaneous Coronary Intervention / ST Elevation Myocardial Infarction / Cardiac Rehabilitation Type of study: Etiology_studies / Guideline / Observational_studies / Prognostic_studies Country/Region as subject: Europa Language: En Journal: Arch Cardiovasc Dis Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2017 Document type: Article Affiliation country: España

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Coronary Artery Disease / Coronary Stenosis / Percutaneous Coronary Intervention / ST Elevation Myocardial Infarction / Cardiac Rehabilitation Type of study: Etiology_studies / Guideline / Observational_studies / Prognostic_studies Country/Region as subject: Europa Language: En Journal: Arch Cardiovasc Dis Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2017 Document type: Article Affiliation country: España