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Posted by on Oct 27, 2013 in Coronary artery disease | 0 comments

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In a nutshell

This study evaluated the effect of the severity of coronary artery disease (CAD) and the presence of culprit lesions in patients with a heart attack undergoing a percutaneous coronary intervention.

Some background

A heart attack is a cardiovascular condition in which the blood supply to the heart is suddenly blocked causing damage to the heart muscle. A heart attack is medically referred to as a myocardial infarction (MI). Most MIs are caused by coronary artery disease (CAD). CAD results from the narrowing of coronary arteries (the arteries that supply blood and oxygen to the heart) due to gradual build-up of plaque (fatty material) within their walls, blocking the coronary arteries, thus starving the heart of blood and oxygen. 

Presence of culprit lesions (lesions in the walls of the coronary arteries) is also thought to fuel MI and other cardiovascular diseases. Culprit lesions can be diagnosed through a coronary angiography (a technique that uses x-rays to visualize the inside the coronary arteries). Treatment for a MI usually involves placement of a stent (a tube placed in the coronary artery that keeps the artery open). This is done through a percutaneous coronary intervention (PCI), which is similar to a coronary angiography. This article aimed to evaluate the long-term outcomes of patients with a culprit lesion who undergo a PCI for a presumed MI and the association with the severity of CAD.

Methods & findings

A total of 539 patients who underwent emergent PCI for a potential MI were involved in this study. Culprit lesions were identified in 364 patients. Among 175 patients who were free from culprit lesions, 110 patients had non-obstructive CAD while 65 patients had no CAD.

Results showed that patients without CAD had about half the risk of major adverse cardiovascular events such as MI, stroke, sudden death compared to those with CAD, regardless of the presence of a culprit lesion. There was no difference in survival between patients with CAD who had culprit lesion and those without any lesions. Patients without CAD had a significantly lower mortality rate.

The bottom line

In summary, this study showed that, regardless of the presence or absence of culprit lesions, the severity of CAD influences long term outcomes of patients with a MI undergoing a PCI. 

What’s next?

Consult your doctor on the best treatment in your situation.

Published By :

The American journal of cardiology

Date :

Sep 21, 2013

Original Title :

Long-Term Outcomes of Patients Sent Emergently to the Catheterization Laboratory for Possible Primary Percutaneous Coronary Intervention.

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