Long-term prognostic impact of the left anterior descending coronary artery as the STEMI-related culprit vessel: subanalysis of the EXAMINATION-EXTEND trial
Year: 2024
Type: article
Abstract: Introduction and objectives: There is limited data on the impact of the culprit vessel on very long-term outcomes after ST-elevation myocardial infarction (STEMI). The aim was to analyze the impact of the left anterior descending coronary artery (LAD) as the culprit vessel of STEMI on very long-term outcomes. Methods: We analyzed patients included in the EXAMINATION-EXTEND study (NCT04462315) treated with everolimus-eluting stents or bare-metal stents after STEMI (1498 patients) and stratified according to the culprit vessel (LAD vs other vessels). The primary endpoint was the patient-oriented composite endpoint (POCE), including all-cause mortality, myocardial infarction (MI) or revascularization at 10 years. Secondary endpoints were individual components of POCE, device-oriented composite endpoint and its individual components and stent thrombosis. We performed landmark analyses at 1 and 5 years. All endpoints were adjusted with multivariable Cox regression models. Results: = .041) at 1-year. Conclusions: In a contemporary cohort of STEMI patients, there were no differences in POCE between LAD as the STEMI-related culprit vessel and other vessels at 10 years follow-up. However, all-cause mortality was more common in the LAD-STEMI group within the first year after STEMI.
Authors: Pablo Vidal-Calés, Kamil Bujak, Riccardo Rinaldi, Anthony Salazar-Rodríguez, Luis Ortega-Paz, Josep Gómez-Lara, Víctor Jiménez-Díaz, Marcelo Jiménez, Pilar Jiménez-Quevedo, Roberto Diletti, Pascual Bordes, Gianluca Campo, Antonio Silvestro, Jaume Maristany, Xacobe Flores, Antonio De Miguel-Castro, Andrés Íñiguez, Alfonso Ielasi, Maurizio Tespili, Mattie Lenzen, Nieves Gonzalo, Matteo Tebaldi, Simone Biscaglia, Rafael Romaguera, Patrick W. Serruys, Manel Sabaté, and, Salvatore Brugaletta
Institutions: Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Medical University of Silesia, University of Florida, University of Florida Health Science Center, Bellvitge University Hospital, Institut d'Investigació Biomédica de Bellvitge, Hospital de Sant Pau, Hospital Clínico San Carlos, University of Ferrara, Arcispedale Sant'Anna, Azienda Ospedaliera Bolognini Seriate, Hospital Universitario Son Dureta, Complexo Hospitalario Universitario A Coruña, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Ollscoil na Gaillimhe – University of Galway
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4405418760