Abstract
Greater lesion complexity, according to the American College of Cardiology and American
Heart Association, has been associated with decreased success rates of percutaneous
coronary intervention. We hypothesized that greater lesion complexity after fibrinolytic
administration for ST-segment elevation myocardial infarction would similarly be associated
with increased mortality and other adverse events at 30 days. We studies 2,605 patients
from the Thrombolysis In Myocardial Infarction 10B and 14, Integrilin and Tenecteplase
in Acute Myocardial Infarction, ENTIRE, and FASTER studies. For all studies, angiographic
outcomes were assessed immediately after fibrinolytic administration and clinical
outcomes were assessed at 30 days. Greater lesion complexity was associated with poorer
epicardial flow and decreased myocardial perfusion at 60 minutes and after percutaneous
coronary intervention and with a higher risk of shock and mortality within 30 days.
In a multivariate model, type C lesion complexity remained associated with an increased
30-day mortality rate.
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Article info
Publication history
Accepted:
March 15,
2004
Received in revised form:
March 15,
2004
Received:
November 11,
2003
Footnotes
☆This study was supported in part by a grant from Genentech, Inc., South San Francisco, California (TIMI 10B); Centocor and Eli Lilly, Inc., Malvern, Pennsylvania, and Indianapolis, Indiana (TIMI 14); Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts (INTEGRITI); Merck & Co. Inc., Blue Bell, Pennsylvania (FASTER); and Aventis Pharma, Antony, France (ENTIRE).
Identification
Copyright
© 2004 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
