Table 1 Comparison of patient’s characteristics between the non-difficult group and the difficult group.
From: Factors associated with difficulty in crossing the culprit lesion of acute myocardial infarction
All n = 937 | Non-difficult group n = 876 | Difficult group n = 61 | p-value | |
|---|---|---|---|---|
Age, years | 70.2 ± 12.5 | 70.0 ± 12.6 | 73.8 ± 9.7 | 0.027 |
Male, n (%) | 711 (75.9) | 669 (76.4) | 42 (68.9) | 0.185 |
Physical examination | ||||
Height (cm) | 161.7 ± 10.2 (n = 934) | 161.9 ± 10.2 (n = 873) | 158.9 ± 9.9 | 0.021 |
Body weight (kg) | 63.1 ± 13.6 (n = 934) | 63.3 ± 13.6 (n = 873) | 60.5 ± 13.2 | 0.080 |
Systolic blood pressure at admission (mmHg) | 140.3 ± 32.8 (n = 932) | 140.0 ± 32.6 (n = 871) | 144.7 ± 35.3 | 0.283 |
Diastolic blood pressure at admission (mmHg) | 80.5 ± 20.5 (n = 931) | 80.4 ± 20.3 (n = 870) | 82.0 ± 22.6 | 0.566 |
Heart rate at admission (beat per minute) | 82.0 ± 22.3 (n = 933) | 81.4 ± 21.5 (n = 872) | 89.3 ± 31.0 | 0.123 |
Underlying disease | ||||
Hypertension, n (%) | 762/936 (81.4) | 708/875 (80.9) | 54 (88.5) | 0.140 |
Diabetes mellitus, n (%) | 417/931 (44.8) | 384/871 (44.1) | 33/60 (55.0) | 0.100 |
Dyslipidemia, n (%) | 583/932 (62.6) | 539/871 (61.9) | 44 (72.1) | 0.110 |
Hemodialysis, n (%) | 89 (9.5) | 79 (9.0) | 10 (16.4) | 0.057 |
History of previous PCI, n (%) | 209 (22.3) | 187 (21.3) | 22 (36.1) | 0.008 |
History of previous CABG, n (%) | 38 (4.1) | 34 (3.9) | 4 (6.6) | 0.306 |
History of previous MI, n (%) | 148 (15.8) | 140 (16.0) | 8 (13.1) | 0.553 |
Current smoker, n (%) | 291/920 (31.6) | 277/860 (32.2) | 14/60 (23.3) | 0.153 |
Medication before admission | ||||
Aspirin, n (%) | 304/930 (32.7) | 273/870 (31.4) | 31/60 (51.7) | 0.001 |
Thienopyridine, n (%) | 181/930 (19.5) | 161//870 (18.5) | 20/60 (33.3) | 0.005 |
Beta-blocker, n (%) | 222/911 (24.4) | 203/852 (23.8) | 19/59 (32.2) | 0.147 |
ACE-inhibitor, ARB, n (%) | 370/912 (40.6) | 344/853 (40.3) | 26/59 (44.1) | 0.572 |
Calcium channel blocker, n (%) | 347/910 (38.1) | 325/851 (38.2) | 22/59 (37.3) | 0.890 |
Statin, n (%) | 327/917 (35.7) | 299/858 (34.8) | 28/59 (47.5) | 0.050 |
Diuretic, n (%) | 124/915 (13.6) | 112/856 (13.1) | 12/59 (20.3) | 0.115 |
Hypoglycemic agents, n (%) | 242/920 (26.3) | 217/861 (25.2) | 25/59 (42.4) | 0.004 |
Insulin, n (%) | 63/922 (6.8) | 57/863 (6.6) | 6/59 (10.2) | 0.294 |
Laboratory data at admission | ||||
Serum creatinine (mg/dl) | 1.66 ± 2.31 | 1.61 ± 2.24 | 2.30 ± 3.16 | 0.419 |
Estimated GFR (ml/min/1.73m2) | 60.9 ± 31.8 | 61.0 ± 29.6 | 60.3 ± 54.7 | 0.242 |
Hemoglobin (g/dl) | 13.2 ± 2.14 | 13.2 ± 2.09 | 12.5 ± 2.61 | 0.016 |
BNP (pg/ml) | 420.3 ± 686.3 (n = 891) | 394.4 ± 656.1 (n = 831) | 778.3 ± 953.5 (n = 60) | < 0.001 |
Killip class | 0.003 | |||
1 or 2 | 736 (78.5) | 697 (79.6) | 39 (63.9) | |
3 | 99 (10.6) | 85 (9.7) | 14 (23.0) | |
4 | 102 (10.9) | 94 (10.7) | 8 (13.1) | |
Cardiac arrest at prehospital or ER, n (%) | 55 (5.9) | 48 (5.5) | 7 (11.5) | 0.054 |
Shock vital at prehospital or ER, n (%) | 117 (12.5) | 109 (12.4) | 8 (13.1) | 0.878 |
Admission within 24 h of onset | 796/932 (85.4) | 751/871 (86.2) | 45 (73.8) | 0.008 |
STEMI (vs NSTEMI) | 563 (60.1) | 533 (60.8) | 30 (49.2) | 0.072 |
Culprit lesion | 0.456 | |||
Left main – left anterior descending artery, n (%) | 477 (50.9) | 443 (50.6) | 34 (55.7) | |
Right coronary artery, n (%) | 311 (33.2) | 296 (33.8) | 15 (24.6) | |
Left circumflex, n (%) | 141 (15.0) | 130 (14.8) | 11 (18.0) | |
Graft, n (%) | 8 (0.9) | 7 (0.8) | 1 (1.6) | |
Number of narrowed coronary arteries | 0.031 | |||
1 vessel disease, n (%) | 403 (43.0) | 382 (43.6) | 21 (34.4) | |
2 vessel disease, n (%) | 311 (33.2) | 294 (33.6) | 17 (27.9) | |
3 vessel disease, n (%) | 223 (23.8) | 200 (22.8) | 23 (37.7) | |
Left main trunk lesion, n (%) | 101 (10.8) | 95 (10.8) | 6 (9.8) | 0.806 |
Left main trunk bifurcation lesion, n (%) | 53 (5.7) | 50 (5.7) | 3 (4.9) | 0.796 |
Ostia lesion, n (%) | 77 (8.2) | 69 (7.9) | 8 (13.1) | 0.150 |
Bifurcation lesion, n (%) | 217 (23.2) | 207 (23.6) | 10 (16.4) | 0.195 |
Initial TIMI flow grade of culprit | 0.003 | |||
0 | 350 (37.4) | 319 (36.4) | 31 (50.8) | |
1 | 88 (9.4) | 79 (9.0) | 9 (14.8) | |
2 | 160 (17.1) | 148 (16.9) | 12 (19.7) | |
3 | 339 (36.2) | 330 (37.7) | 9 (14.8) | |
TIMI Thrombus grade | 0.002 | |||
0 | 0 | 0 | 0 | |
1 | 479 (51.1) | 458 (52.3) | 21 (34.4) | |
2 | 34 (3.6) | 34 (3.9) | 0 | |
3 | 50 (5.3) | 49 (5.6) | 1 (1.6) | |
4 | 20 (2.1) | 18 (2.1) | 2 (3.3) | |
5 | 354 (37.8) | 317 (36.2) | 37 (60.7) | |
Lesion length (mm) | 16.1 ± 10.2 | 16.0 ± 10.1 | 18.0 ± 11.7 | 0.279 |
Reference diameter (mm) | 2.57 ± 0.75 | 2.59 ± 0.75 | 2.18 ± 0.65 | < 0.001 |
Proximal reference diameter (mm) | 2.72 ± 0.66 | 2.79 ± 0.65 | 2.43 ± 0.65 | < 0.001 |
Tortuosity | 0.481 | |||
Mild tortuosity, n (%) | 815 (87.0) | 765 (87.3) | 50 (82.0) | |
Moderate tortuosity, n (%) | 87 (9.3) | 79 (9.0) | 8 (13.1) | |
Excessive tortuosity, n (%) | 35 (3.7) | 32 (3.7) | 3 (4.9) | |
Eccentricity | 0.088 | |||
Concentric, n (%) | 871 (93.0) | 811 (92.6) | 60 (98.4) | |
Eccentric, n (%) | 66 (7.0) | 65 (7.4) | 1 (1.6) | |
Calcification | < 0.001 | |||
None-mild, n (%) | 709 (75.7) | 680 (77.6) | 29 (47.5) | |
Moderate, n (%) | 132 (14.1) | 113 (12.9) | 19 (31.1) | |
Severe, n (%) | 96 (10.2) | 83 (9.5) | 13 (21.3) | |
Type of obstruction site | < 0.001 | |||
Blunt | 171 (18.2) | 131 (15.0) | 40 (65.6) | |
Tapered | 766 (81.7) | 745 (85.0) | 21 (34.4) | |
In-stent lesion | 80 (8.5) | 69 (7.9) | 11 (18.0) | 0.006 |
The presence of collateral to the culprit lesion (Rentrop grade) | 0.001 | |||
0 | 701 (74.8) | 668 (76.3) | 33 (54.1) | |
1 | 165 (17.6) | 148 (16.9) | 17 (27.9) | |
2 | 66 (7.0) | 56 (6.4) | 10 (16.4) | |
3 | 5 (0.5) | 4 (0.5) | 1 (1.6) | |
Occurrence of slow flow in PCI, n (%) | 63 (6.7) | 61 (7.0) | 2 (3.3) | 0.267 |
Approach site | 0.070 | |||
Trans-radial coronary intervention, n (%) | 565 (60.3) | 536 (61.2) | 29 (47.5) | |
Trans-brachial coronary intervention, n (%) | 32 (3.4) | 28 (3.2) | 4 (6.6) | |
Trans-femoral coronary intervention, n (%) | 340 (36.3) | 312 (35.6) | 28 (45.9) | |
PCI procedure | 0.009 | |||
Plain old balloon angioplasty, n (%) | 54 (5.8) | 46 (5.3) | 8 (13.1) | |
Aspiration only, n (%) | 6 (0.6) | 6 (0.7) | 0 | |
Drug coating balloon angioplasty, n (%) | 42 (4.5) | 37 (4.2) | 5 (8.2) | |
Bare metal stent, n (%) | 23 (2.5) | 22 (2.5) | 1 (1.6) | |
Drug eluting stent, n (%) | 803 (85.7) | 758 (86.5) | 45 (73.8) | |
POBA and aspiration, n (%) | 6 (0.6) | 4 (0.5) | 2 (3.3) | |
Other, n (%) | 3 (0.3) | 3 (0.3) | 0 | |
Size of guiding catheter (Fr) | < 0.001 | |||
6 | 584 (62.4) | 563 (64.3) | 21 (34.4) | |
7 | 343 (36.6) | 307 (35.0) | 36 (59.0) | |
8 | 10 (1.1) | 6 (0.7) | 4 (6.6) | |
Number of guiding catheters | < 0.001 | |||
1 | 868 (92.6) | 822 (93.8) | 46 (75.4) | |
2 | 61 (6.5) | 49 (5.6) | 12 (19.7) | |
≥ 3 | 8 (0.9) | 5 (0.6) | 3 (4.9) | |
Number of guide wires | < 0.001 | |||
1 | 506 (54.0) | 506 (57.8) | 0 | |
2 | 315 (33.6) | 287 (32.8) | 28 (45.9) | |
≥ 3 | 116 (12.4) | 83 (9.5) | 33 (54.1) | |
Number of stents | 0.002 | |||
0 | 121 (12.9) | 105 (12.0) | 16 (26.2) | |
1 | 710 (75.8) | 676 (77.2) | 34 (55.7) | |
2 | 98 (10.5) | 88 (10.0) | 10 (16.4) | |
≥ 3 | 8 (0.9) | 7 (0.8) | 1 (1.6) | |
Number of balloons | < 0.001 | |||
0 | 29 (3.1) | 29 (3.3) | 0 | |
1 | 409 (43.6) | 392 (44.7) | 17 (27.9) | |
2 | 350 (37.4) | 328 (37.4) | 22 (36.1) | |
≥ 3 | 149 (15.9) | 127 (14.5) | 22 (36.1) | |
Use of guide-extension-catheter, n (%) | 94 (10.0) | 81 (9.2) | 13 (21.3) | 0.002 |
Use of microcatheter, n (%) | 279 (29.8) | 222 (25.3) | 57 (93.4) | < 0.001 |
Use of aspiration catheter, n (%) | 152 (16.2) | 146 (16.7) | 6 (9.8) | 0.162 |
Use of rotational coronary atherectomy, n (%) | 42 (4.5) | 37 (4.2) | 5 (8.2) | 0.147 |
IVUS guide, n (%) | 907 (96.8) | 848 (96.8) | 59 (96.7) | 0.972 |
OCT/OFDI guide, n (%) | 19 (2.0) | 19 (2.2) | 0 | 0.245 |
Temporary pacemaker, n (%) | 67 (7.2) | 63 (7.2) | 4 (6.6) | 0.852 |
Intra-aortic balloon pumping support, n (%) | 97 (10.4) | 90 (10.3) | 7 (11.5) | 0.766 |
V-A ECMO, n (%) | 28 (3.0) | 26 (3.0) | 2 (3.3) | 0.890 |
Amount of contrast media (ml) | 126.6 ± 48.7 | 125.5 ± 47.8 | 142.8 ± 58.1 | 0.010 |
Fluoroscopy time (minutes) | 24.7 ± 14.1 | 23.4 ± 12.5 | 43.0 ± 21.9 | < 0.001 |
