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Patent coronary artery and myocardial infarction in the era of primary angioplasty: assessment of an old problem in a new setting with data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR).
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
2010 (English)In: EuroIntervention, ISSN 1969-6213, Vol. 6, no 5, 590-595 p.Article in journal (Refereed) Published
Abstract [en]

Aims: The purpose of this study was to evaluate factors that contribute to a patent IRA (infarct - related artery) and the prognostic impact of a patent IRA in patients with ST-elevation myocardial infarction.

Methods and results: Using the Swedish angiography and angioplasty registry (SCAAR) we included all patients with STEMI and one-vessel coronary artery disease who underwent primary PCI of the culprit lesion only from May 2005 to December 2007. A patent IRA was found in 1,104 of 3,284 patients. Patients with an occluded IRA had significantly increased 7-day mortality (HR, 3.03, 95% CI 1.68-5.46, P<0.001). The incidence of an occluded IRA increased with higher age, in patients over 80 years of age (OR, 1.23, 95% CI; 0.92-1.64), lower in patients on lipid-lowering drugs (OR, 0.68, 95% CI; 0.54-0.86) and lower in patients pre-treated with heparin (OR 0.71, 95% CI; 0.60-0.83) or GPIIb/IIIa receptor blockade (OR 0.77, 95% CI; 0.61-0.97). Treatment with acetylsalicylic acid or clopidogrel had no effect on IRA patency.

Conclusions: IRA patency was associated with a lower 7-day mortality. Older STEM I patients and patients not taking lipid-lowering drugs or pre-treated with heparin or GPIIb/IIIa receptor blockers seem to constitute risk groups for having an occluded IRA.

Place, publisher, year, edition, pages
2010. Vol. 6, no 5, 590-595 p.
Keyword [en]
Coronary angioplasty, acute myocardial infarction prognosis, occlusive disease, reperfusion therapy, spontaneous reperfusion
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:uu:diva-151843DOI: 10.4244/EIJV6I5A99ISI: 000294135000009PubMedID: 21044912OAI: oai:DiVA.org:uu-151843DiVA: diva2:411457
Available from: 2011-04-18 Created: 2011-04-18 Last updated: 2015-08-14Bibliographically approved

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Lagerqvist, Bo
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