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Recurrent Myocardial Infarction After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Overview of attention for article published in American Journal of Cardiology, October 2013
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Title
Recurrent Myocardial Infarction After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction
Published in
American Journal of Cardiology, October 2013
DOI 10.1016/j.amjcard.2013.08.039
Pubmed ID
Authors

Wouter J. Kikkert, Loes P. Hoebers, Peter Damman, Krystien V.V. Lieve, Bimmer E.P.M. Claessen, Marije M. Vis, Jan Baan, Karel T. Koch, Robbert J. de Winter, Jan J. Piek, Jan G.P. Tijssen, Jose P.S. Henriques

Abstract

The determinants and prognostic value of recurrent myocardial infarction (MI) in a contemporary cohort of ST-segment elevation MI patients treated with primary percutaneous coronary intervention (PPCI) and stenting are currently unknown. We investigated the predictors and prognostic impact of recurrent MI on subsequent clinical outcome in 1,700 ST-segment elevation MI patients treated with PPCI and stenting between January 1, 2003, and July 31, 2008. Two hundred forty patients had a recurrent MI during a median follow-up of 4 years and 7 months (Kaplan Meier estimate 21.2%). By multivariable analysis, recurrent MI was associated with a higher risk of subsequent cardiac mortality (hazard ratio [HR] 6.86, 95% confidence interval [CI] 4.24 to 8.72), noncardiac mortality (HR 2.02, 95% CI 1.10 to 3.69), stroke (HR 3.68, 95% CI 2.02 to 6.72), and Global Use of Strategies to Open Occluded Coronary Arteries criteria severe or moderate bleeding (HR 3.17, 95% CI 1.79 to 5.60). Early recurrent MI (within 1 day of the initial PPCI) was associated with higher unadjusted cardiac mortality rates (64.4%) compared with recurrent MIs occurring ≥1 day after PPCI. However, after multivariable adjustment, late recurrent MI (occurring >1 year after PPCI) was associated with the highest risk of subsequent cardiac mortality (HR 7.98, 95% CI 5.05 to 12.6). The risk of cardiac death was irrespective of the presence of persistent ST-segment elevation during the recurrent MI. In conclusion, recurrent MI after PPCI remains a relatively common complication in contemporary practice and confers a significantly increased risk of death, stroke, and bleeding.

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Mendeley readers

The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 40 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 18%
Other 6 15%
Student > Postgraduate 6 15%
Student > Ph. D. Student 6 15%
Student > Doctoral Student 2 5%
Other 5 13%
Unknown 8 20%
Readers by discipline Count As %
Medicine and Dentistry 24 60%
Nursing and Health Professions 3 8%
Pharmacology, Toxicology and Pharmaceutical Science 1 3%
Economics, Econometrics and Finance 1 3%
Agricultural and Biological Sciences 1 3%
Other 0 0%
Unknown 10 25%