Aortic Arch Calcification in Predicting Unfavorable Angiographic Outcomes for Patients with ST-Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

IF 2.9 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medical Principles and Practice Pub Date : 2024-01-01 Epub Date: 2024-06-26 DOI:10.1159/000540026

Uğur Köktürk, Orhan Önalan, Mustafa Umut Somuncu, Fahri Çakan, Naile Eriş Güdül, İlke Erbay, Ahmet Avcı

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引用次数: 0

Abstract

Background: Despite advances in treatment, no-reflow, large thrombus burden (LTB), and myocardial blush grade (MBG) are associated with adverse cardiovascular outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). Aortic arch calcification (AAC) is associated with subclinical atherosclerosis and adverse cardiovascular events. We aimed to examine the relationship between AAC and unfavorable angiographic outcomes such as no-reflow, MBG, and LTB in STEMI patients undergoing PCI.

Methods: A total of 269 consecutive patients who presented with STEMI and underwent primary PCI were included in the study prospectively. Patients were divided into 3 groups according to AAC degree: grade 0, grade 1, and grade 2/3. The relationship between AAC and the predictors of unfavorable angiographic outcomes, including LTB, no-reflow, and MBG, was specifically examined.

Results: LTB, no-reflow, and MBG 0/1 were significantly higher in the grade 2/3 AAC group compared to the grade 0 and grade 1 groups (all p < 0.05). Moreover, grade 2/3 AAC was found to be an independent predictor for LTB, MBG 0/1, and no-reflow (p = 0.002, p = 0.005, p = 0.004, respectively). Patients were then classified according to thrombus burden, MBG, and no-reflow status. Grade 2/3 AAC was significantly higher than grade 0/1 AAC in the LTB, MBG 0/1, and no-reflow groups (all p < 0.05).

Conclusion: AAC can be used as a reliable indicator in predicting no-reflow, MBG 0/1, and LTB in STEMI patients undergoing primary PCI.

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主动脉弓钙化在预测接受经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死患者血管造影结果中的作用

背景：尽管治疗手段不断进步，但在接受经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者中，无回流、大血栓负荷（LTB）和心肌淤血等级（MBG）与不良心血管后果相关。主动脉弓钙化（AAC）与亚临床动脉粥样硬化和不良心血管事件有关。我们旨在研究主动脉弓钙化与接受 PCI 的 STEMI 患者的无回流、MBG 和 LTB 等不利血管造影结果之间的关系：研究前瞻性地纳入了 269 例 STEMI 患者，这些患者均接受了初级 PCI 治疗。根据 AAC 程度将患者分为 3 组：0级、1级和2/3级。血管造影结果不佳；根据是否有血流回流分为 2 组，根据血栓负荷分为 LTB 和小 TB 2 组，根据 MBG 在 0-3 之间分为 4 组：结果：与 0 级和 1 级组相比，2/3 级 AAC 组的 LTB、无回流和 MBG 0/1 明显更高（均为 p<0.05）。此外，2/3 级 AAC 是 LTB、MBG 0/1 和无回流的独立预测因子（OR=2.480；95% CI：1.398-4.400；p=0.002，OR=2.364；95% CI：1.296-4.321，p=0.005，OR=4.170；95% CI：1.671-9.100，p=0.004）。然后根据血栓负荷、MBG 和无回流状态对患者进行分类。在LTB、MBG 0/1和无回流组中，2/3级AAC明显高于0/1级AAC（所有P<0.05）：结论：AAC可作为预测接受初治PCI的STEMI患者无复流、MBG 0/1和LTB的可靠指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Principles and Practice 医学-医学：内科

CiteScore

6.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Medical Principles and Practice'', as the journal of the Health Sciences Centre, Kuwait University, aims to be a publication of international repute that will be a medium for dissemination and exchange of scientific knowledge in the health sciences.