Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1828
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dc.contributorFernando, H.en_US
dc.contributorDuffy, S.en_US
dc.contributorLow, A.en_US
dc.contributorDinh, D.en_US
dc.contributorAdrianopoulos, N.en_US
dc.contributorSharma, Ananden_US
dc.contributorKarlheinz, P.en_US
dc.contributorStub, D.en_US
dc.contributorLeong, Kai'Enen_US
dc.contributorAjani, A.en_US
dc.contributorClark, D.en_US
dc.contributorFreeman, M.en_US
dc.contributorSebastian, M.en_US
dc.contributorBrennan, A.en_US
dc.contributorSelkrig, L.en_US
dc.contributorReid, C.en_US
dc.contributorKaye, D.en_US
dc.contributorOqueli, Ernestoen_US
dc.date.accessioned2021-11-30T23:07:18Z-
dc.date.available2021-11-30T23:07:18Z-
dc.date.issued2021-
dc.identifier.govdoc01788en_US
dc.identifier.urihttp://hdl.handle.net/11054/1828-
dc.description.abstractThe short- and long-term implications of identifying totally occluded culprit coronary arteries (TOCCA) in patients presenting with non-ST-elevation myocardial infarction (NSTEMI) have not been well studied. This study compares clinical characteristics, short- and long-term outcomes of patients with NSTEMI identified with TOCCA to that of patients with non-TOCCA undergoing percutaneous coronary intervention (PCI). We analyzed data from patients with NSTEMI undergoing single-vessel PCI within the Melbourne Interventional Group multi-center registry between 2005 and 2017. Those with TOCCA were compared to those with non-TOCCA. The primary endpoint was 30-day major adverse cardiac events (MACE). Secondary endpoints included 12-month MACE and long-term mortality. A total of 6,829 patients with NSTEMI had single-vessel PCI of which 954 (14%) had TOCCA. Most TOCCA were non-left anterior descending (right coronary artery 39% versus circumflex 33% versus left anterior descending 26%; p <0.001). Cardiogenic shock and left ventricular dysfunction were higher in the TOCCA group, but non-TOCCA patients had more baseline comorbidities. Thirty-day MACE was higher in the TOCCA group (6.7% versus 3.8%; p <0.001). Long-term mortality with an average follow-up of 4.9 years was higher in the non-TOCCA group (12% versus 18%, p <0.01). Multivariable Cox-proportional hazards regression identified TOCCA as an independent predictor of 30-day MACE (HR = 1.93; 95%CI: 1.4-2.6), but not long-term mortality, which was predicted by baseline comorbidities. In conclusion, while patients with NSTEMI with TOCCA undergoing PCI represent a more unstable subgroup early on, long-term outcomes appear more dependent on baseline comorbidities.en_US
dc.description.provenanceSubmitted by Gemma Siemensma (gemmas@bhs.org.au) on 2021-11-22T05:21:38Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma (gemmas@bhs.org.au) on 2021-11-30T23:07:18Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2021-11-30T23:07:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2021en
dc.titleTotally occluded culprit coronary artery in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention.en_US
dc.typeJournal Articleen_US
dc.type.specifiedArticleen_US
dc.bibliographicCitation.titleThe American Journal of Cardiologyen_US
dc.bibliographicCitation.volume56en_US
dc.bibliographicCitation.stpage52en_US
dc.bibliographicCitation.endpage57en_US
dc.subject.healththesaurusPCIen_US
dc.subject.healththesaurusPERCUTANEOUS CORONARY INTERVENTIONen_US
dc.subject.healththesaurusSTEMIen_US
dc.subject.healththesaurusMYOCARDIAL INFARCTIONen_US
dc.identifier.doihttps://doi.org/10.1016/j.amjcard.2021.06.043en_US
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