CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

MITRA-FR vs. COAPT: Lessons from two trials with diametrically opposed results Single direct oral anticoagulant therapy in stable patients with atrial fibrillation beyond 1 year after coronary stent implantation Current Status and Future Prospects of Transcatheter Mitral Valve Replacement: JACC State-of-the-Art Review Gut microbiota dysbiosis promotes age-related atrial fibrillation by lipopolysaccharide and glucose-induced activation of NLRP3-inflammasome Detection of Device-Related Thrombosis Following Left Atrial Appendage Occlusion A Comparison Between Cardiac Computed Tomography and Transesophageal Echocardiography​: A Comparison Between Cardiac Computed Tomography and Transesophageal Echocardiography Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke Role of local coronary blood flow patterns and shear stress on the development of microvascular and epicardial endothelial dysfunction and coronary plaque Management and outcomes of patients with left atrial appendage thrombus prior to percutaneous closure Transseptal puncture versus patent foramen ovale or atrial septal defect access for left atrial appendage closure Rivaroxaban Is Associated With Higher Rates of Gastrointestinal Bleeding Than Other Direct Oral Anticoagulants: A Nationwide Propensity Score–Weighted Study
|<<... 169 170 171 172 173 174 175 ...>>|

Clinical TrialPublished on 26 September 2017

JOURNAL：EuroIntervention. Article Link

Clinical Implications of Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention for Chronic Total Occlusion: Role of Antegrade and Retrograde Crossing Techniques

Toma A, Stähli B, Gebhard C et al. Keywords: myocardial infarction; stable angina; death; Chronic coronary total occlusion

ABSTRACT


AIMS - Periprocedural myocardial injury (PMI) is frequently observed after percutaneous coronary interventions (PCI) for chronic total occlusion (CTO). We investigated the prognostic impact of PMI with the antegrade or the retrograde crossing technique.


METHODS AND RESULTS - A total of 1909 patients undergoing CTO PCI were stratified according to the presence/absence of PMI (elevation of cardiac troponin T [cTnT] >5x 99th percentile of normal), and divided according to tertiles of the difference between peak and baseline cTnT within 24 hours (ΔcTnT). The primary endpoint was all-cause mortality at a median follow-up of 3.1 (interquartile range 3.0-4.4) years. PMI occurred in 19.4% and 25.4% after antegrade (n=1447) and retrograde (n=462) procedures (p<0.001). PMI was significantly associated with mortality after antegrade (adjusted HR 1.39, 95% CI 1.02-1.88, p=0.04), but not retrograde CTO PCI (adjusted HR 0.93,95% CI 0.53-1.63, p=0.80, Pint=0.02). With the antegrade, but not the retrograde approach, mortality also increased with tertiles of ΔcTnT (T1: 11.0%, T2: 18.6%, T3: 21.6%, Log Rank p<0.001).


CONCLUSIONS - Periprocedural myocardial injury was significantly associated with all-cause mortality following antegrade, but not retrograde CTO PCI. Hence, the higher risk of PMI following retrograde procedures did not translated into worse survival.

>CBS CBS 2019

> CBS 2019

> CBS 2019 注册

> CBS 2019 会议日程

> CBS 2019 学术征集

> CBS 2019 热点

 CBSMD

> CBSMD 网站注册

> 教育中心

> 荐读文献

> Top 10 阅读文献

> 文献导读
CBS 2019 CBS 2019 主席团 教育中心 科研动态
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top