{
  "abstract": "Background Primary percutaneous coronary intervention (PCI) has significantly improved outcomes for ST-segment elevation myocardial infarction (STEMI) patients. However, the long-term durability of PCI in terms of target lesion failure (TLF) remains unknown.Objectives This study investigates the long-term incidence, predictors and clinical impact of TLF over a 10-year follow-up in STEMI patients treated with primary PCI.Methods From the DANAMI-3 trial, we analysed STEMI patients treated with primary PCI. TLF was defined as a composite of cardiovascular death, target lesion myocardial infarction or target lesion revascularisation. Independent predictors of TLF were identified by Cox regression. Outcomes in high-risk and low-risk groups were evaluated using cumulative incidence functions with competing risk analysis.Results Of 2217 patients (median follow-up of 10.7 years), 443 (20.0%) experienced TLF. TLF occurred in 5.6% within the first year after PCI and continued at a constant annual rate of 1.6% thereafter. All-cause mortality, any MI or any revascularisation occurred in 961 (43%) patients, and TLF constitutes 46% of the total patient-oriented events. Multivariable Cox regression identified age, hypertension, previous AMI and Killip class II–IV as independent predictors of an increased risk of TLF, whereas PCI with drug-eluting stents was associated with a reduced risk of TLF. Patients with ≥1 high-risk feature had a twofold greater risk of TLF compared with those without (HR 2.05, 95% CI 1.65 to 2.55, p<0.001).Conclusions One in five STEMI patients treated with primary PCI experiences TLF within 10 years, accounting for a significant proportion of any mortality, any MI or any revascularisation, with sustained occurrence rates beyond the first year.Trial registration number NCT01960933.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Burcu Tas Özbek"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Utsho Islam"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Jasmine Melissa Marquard"
    },
    {
      "affiliations": [
        "Department of Cardiology, Zealand University Hospital Roskilde, Roskilde, Denmark"
      ],
      "name": "Henning Kelbaek"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Joakim B Kunkel"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Lene Holmvang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Hans-Henrik Tilsted"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Frants Pedersen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Lars Koeber"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Dan Hofsten"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark"
      ],
      "name": "Ashkan Eftekhari"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark"
      ],
      "name": "Bent Raungaard"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark"
      ],
      "name": "Hans Erik Bøttker"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark"
      ],
      "name": "Christian Juhl Terkelsen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark"
      ],
      "name": "Evald Christiansen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Ibrahim Mohammed Abdul Khalek"
    },
    {
      "affiliations": [
        "Department of Cardiology, Odense Universitetshospital, Odense, Denmark"
      ],
      "name": "Lisette Okkels Jensen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Thomas Engstrøm"
    },
    {
      "affiliations": [
        "Department of Cardiology, Rigshospitalet Hjertecentret, Copenhagen, Denmark"
      ],
      "name": "Jacob Thomsen Lønborg"
    }
  ],
  "title": "Ten-year target lesion failure in patients treated with primary PCI: results from DANAMI-3",
  "uid": "0738ede9-6b87-565b-9a03-ac72be62f002"
}