Benefit of revascularization in non-infarct-related artery in multivessel disease patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
This study compared the prognosis of ST-elevation myocardial infarction (STEMI) in patients with multivessel disease (MVD) with that of single vessel disease (SVD) and investigated the revascularization benefit of noninfarct-related artery (IRA) in MVD patients undergoing primary percutaneous coronary intervention (PCI). Between 2002 and 2009, 1278 patients with STEMI underwent primary PCI. Of these patients, 717 (56.1%) with SVD (only IRA obstruction) were placed in group A, while 561 (43.9%) with MVD (Group B) were further categorized into group 1 (PCI for IRA) and group 2 (staged PCI for IRA+non-IRA). The results demonstrated a lower degree of successful reperfusion in IRA and higher 30-day and 1-year cumulative mortality rates in group B (P < 0.001). While there was no difference in successful reperfusion in IRA between group 1 and group 2, the 30-day and one-year cumulative mortality rates were higher in group 1. Multivariate analysis identified MVD as an independent predictor of 1-year mortality (P < 0.001). In conclusion, patients with subsequent PCI for MVD had better 30-day and 1-year outcomes than those with conservative treatment.
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaosiung, Taiwan, ROC.
Huang-Chung
HC
Chen
Tzu-Hsien
TH
Tsai
Hsiu-Yu
HY
Fang
Cheuk-Kwan
CK
Sun
Yu-Chun
YC
Lin
Steve
S
Leu
Sheng-Ying
SY
Chung
Han-Tan
HT
Chai
Cheng-Hsu
CH
Yang
Yuan-Kai
YK
Hsien
Chiung-Jen
CJ
Wu
Hon-Kan
HK
Yip
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000502:physiology