Heart Failure in Post-MI Patients With Persistent IRA Occlusion: Prevalence,Risk Factors,and the Long-Term Effect of PCI in the Occluded Artery Trial (OAT) |
| |
| Authors: | Rahul R Jhaveri Harmony R Reynolds Stuart D Katz Raban Jeger Elzbieta Zinka Sandra A Forman Gervasio A Lamas Judith S Hochman |
| |
| Institution: | 1. Cardiovascular Clinical Research Center, Leon Charney Division of Cardiology, New York University School of Medicine, New York, NY;2. Cardiology University Hospital, Basel, Switzerland;3. Division of Cardiology, Voivode Hospital, Koszalin, Poland;4. Clinical Trials and Surveys Corporation, Owings Mills, MD;5. Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL;1. Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California;2. Division of Nuclear Medicine and Molecular Imaging, Stanford University School of Medicine, Stanford, California;1. Department of Neurology, Program in Trauma, University of Maryland Medical Center, Baltimore, MD, United States;2. Department of Neurology, Columbia University Medical Center, New York, NY, United States;3. Department of Neurosurgery, Columbia University Medical Center, New York, NY, United States;1. Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;2. Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois;3. Veteran''s Affairs Medical Center and Virginia Commonwealth University Health System, Richmond, Virginia;4. Department of Emergency Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee;5. Veteran''s Affairs Medical Center and University of California, San Diego, California;1. Department of Cardiology, Michael E. DeBakey Veterans Administration Medical Center, Baylor College of Medicine, Houston, Texas;2. Baylor College of Medicine, Houston, Texas;3. School of Public Health, University of Texas Health Science Center, Houston, Texas;1. Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio;2. Department of Cell Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;3. Department of Medicine, Stanford University School of Medicine, Stanford, California;1. Division of Electrophysiology, Department of Cardiovascular Medicine, Hospital of Westfälische Wilhelms-University, University of Münster, Münster, Germany;2. Department of Biology, Gilead Sciences, Foster City, CA;3. Department of Medical Informatics and Biomathematics, University of Münster, Germany |
| |
| Abstract: | BackgroundThe incidence and predictors of heart failure (HF) after myocardial infarction (MI) with modern post-MI treatment have not been well characterized.Methods and ResultsA total of 2,201 stable patients with persistent infarct-related artery occlusion >24 hours after MI with left ventricular ejection fraction <50% and/or proximal coronary artery occlusion were randomized to percutaneous intervention plus optimal medical therapy (PCI) or optimal medical therapy (MED) alone. Centrally adjudicated HF hospitalizations for New York Heart Association (NYHA) III/IV HF and mortality were determined in patients with and without baseline HF, defined as a history of HF, Killip Class >I at index MI, rales, S3 gallop, NYHA II at randomization, or NYHA >I before index MI. Long-term follow-up data were used to determine 7-year life-table estimated event rates and hazard ratios. There were 150 adjudicated HF hospitalizations during a mean follow-up of 6 years with no difference between the randomized groups (7.4% PCI vs. 7.5% MED, P = .97). Adjudicated HF hospitalization was associated with subsequent death (44.0% vs. 13.1%, HR 3.31, 99% CI 2.21–4.92, P < .001). Baseline HF (present in 32% of patients) increased the risk of adjudicated HF hospitalization (13.6% vs. 4.7%, HR 3.43, 99% CI 2.23–5.26, P < .001) and death (24.7% vs. 10.8%, HR 2.31, 99% CI 1.71–3.10, P < .001).ConclusionsIn the overall Occluded Artery Trial (OAT) population, adjudicated HF hospitalizations occurred in 7.5% of subjects and were associated with increased risk of subsequent death. Baseline or prior HF was common in the OAT population and was associated with increased risk of hospitalization and death. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
