Triggering type and long-term survival following ST segment elevation-myocardial infarction treated with primary percutaneous coronary intervention.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Coronary artery disease Pub Date : 2024-11-05 DOI:10.1097/MCA.0000000000001455

Moaad Slieman, Inbal Greenberg, Zach Rozenbaum, Yoav Granot, Yacov Shacham, David Zahler, Maayan Konigstein, Amir Halkin, Shmuel Banai, Jeremy Ben-Shoshan

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Abstract

Background: Physical and emotional stress are recognized triggers of acute coronary syndromes, including ST segment elevation-myocardial infarction (STEMI). We have previously shown that identifiable triggers precede symptoms in over one-third of STEMI patients and inversely correlate with the extent of coronary artery disease (CAD). This study aims to investigate the association between trigger type (physical vs. emotional) and long-term mortality in STEMI patients treated with primary percutaneous coronary intervention (PCI).

Methods: This retrospective, single-center observational study included all patients admitted with an STEMI diagnosis from January 2008 to December 2013. Physical and emotional triggers were identified retrospectively from patient records. Mortality data were obtained from the Israeli Ministry of Health.

Results: Of 1345 consecutive STEMI patients treated with primary PCI, mortality data were available for 1267 patients (median age: 61 years). A trigger preceding symptoms onset was identified in 36.5% of patients, with 85% experiencing physical stress and 15% emotional stress. Triggered STEMI patients tended to be younger with fewer comorbidities and lower incidence of multiple vessel CAD compared with nontriggered patients. Notably, emotionally triggered STEMI patients exhibited improved long-term survival compared with those without emotional triggers or with physical triggers. predictor of enhanced long-term survival post-PCI compared with physical triggering. Emotional triggering was identified as an independent.

Conclusion: Patients with emotionally triggered STEMI showed less extensive CAD and improved long-term survival following PCI compared with those with physically triggered STEMI. These findings highlight the importance of considering both the presence and type of trigger in the management of STEMI patients and their long-term prognosis.

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经皮冠状动脉介入治疗 ST 段抬高型心肌梗死后的触发类型和长期存活率。

背景：身体和情绪压力是公认的急性冠状动脉综合征（包括 ST 段抬高型心肌梗死）的诱发因素。我们以前的研究表明，在超过三分之一的 STEMI 患者中，可识别的诱发因素出现在症状出现之前，并且与冠状动脉疾病（CAD）的程度成反比。本研究旨在探讨在接受经皮冠状动脉介入治疗（PCI）的 STEMI 患者中，诱因类型（身体诱因与情绪诱因）与长期死亡率之间的关系：这项回顾性单中心观察研究纳入了 2008 年 1 月至 2013 年 12 月期间所有确诊为 STEMI 的入院患者。从患者病历中回顾性地确定了身体和情绪诱因。死亡率数据来自以色列卫生部：在1345名接受初级PCI治疗的连续STEMI患者中，有1267名患者（中位年龄：61岁）的死亡数据可用。36.5%的患者在发病前有诱发因素，其中85%的患者有身体压力，15%的患者有情绪压力。与未触发的患者相比，触发的 STEMI 患者往往更年轻，合并症更少，多血管 CAD 的发生率更低。值得注意的是，与无情绪触发或有物理触发的患者相比，有情绪触发的 STEMI 患者的长期生存率更高。情感触发被认为是一个独立的因素：结论：与物理触发 STEMI 的患者相比，情绪触发 STEMI 的患者显示出较少的广泛 CAD，PCI 后的长期生存率也有所提高。这些发现凸显了在治疗 STEMI 患者及其长期预后时考虑触发因素的存在和类型的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.