Impact of completeness of revascularization by coronary intervention on exercise capacity early after acute ST-elevation myocardial infarction

Journal of Cardiothoracic Surgery

Wei Gao¹  Lijun Guo¹  Fuchun Zhang¹  Jin Bai¹  Wei Zhao¹ 

[1] Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China

关键词: Exercise capacity;    Multivessel disease;    Revascularization;    Angioplasty;    Percutaneous coronary intervention;    Myocardial infarction;   

Others  :  811263
DOI  :  10.1186/1749-8090-9-50

 received in 2013-06-13, accepted in 2014-03-11,  发布年份 2014

【 摘 要 】

Background

The importance of achieving complete revascularization by percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (MI) on exercise capacity remains unclear.

Objective

To compare exercise capacity early after acute ST-elevation myocardial infarction (STEMI), in patients receiving PCI with stenting, between those completely revascularized (CR) and those incompletely revascularized (IR).

Methods

We retrospectively reviewed 326 patients [single-vessel disease (SVD) group, 118 patients; multivessel disease (MVD) with CR group, 112 patients; MVD with IR group, 96 patients] who underwent cardiopulmonary exercise testing 7–30 days after STEMI to measure peak oxygen uptake (VO_2peak), oxygen uptake at anaerobic threshold (VO_2AT), and peak oxygen pulse. Demographic data, presence of concomitant diseases, STEMI characteristics, and echocardiography and angiography findings were evaluated.

Results

Most patients were male (89.0%) and mean age was 55.6 ± 11.2 years. Ischemic ST deviation occurred in 7.1%, with no significant difference between groups. VO_2peak and VO_2AT did not differ significantly between groups, despite a trend to be lower in the CR and IR groups compared with the SVD group. Peak oxygen pulse was significantly higher in the SVD group than in the IR group (p = 0.005). After adjustment for age, gender, body mass index, cardiovascular risk factors, MI characteristics and echocardiography parameters, CR was not an independent predictor of VO_2peak (OR = −0.123, 95% confidence interval [CI] -2.986 to 0.232, p = 0.093), VO_2AT (OR = 0.002, 95% CI 1.735 to 1.773, p = 0.983), or peak oxygen pulse (OR = −0.102, 95% CI −1.435 to 0.105, p = 0.090).

Conclusion

CR in patients with STEMI treated with PCI for multivessel disease might show no benefit on short-term exercise tolerance over IR.

【 授权许可】

   
2014 Zhao et al.; licensee BioMed Central Ltd.

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