title: Impact of multivessel coronary disease on one-year clinical outcomes and five-year mortality in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention.
abstract: BACKGROUND
  Multivessel coronary disease (MVD) occurs in approximately 40-65% of patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI), and is associated with significantly increased morbidity and mortality rates.
  
  
  OBJECTIVE
  To evaluate the impact of MVD on in-hospital and long-term clinical outcomes in patients with STEMI and PCI, and to compare these results with those from a group of patients with a single coronary vessel disease (SVD).
  
  
  METHODS
  Consecutive patients with STEMI treated with PCI were included in the analysis. Patients were divided into two groups: patients with SVD (n = 828, 46.6%) and patients with MVD (n = 948, 53.4%). Clinical follow-up was performed at 12 months, and five-year mortality was assessed. Major adverse cardiac events (MACE) at 12-month follow-up were defined as death (from any cause), stroke, need for percutaneous or any surgical coronary artery revascularisation, and non-fatal myocardial infarction.
  
  
  RESULTS
  The in-hospital mortality was 2.9% vs 9.5% (p < 0.0001) and the five-year mortality was 11.9% vs 23.8% (p < 0.0001), for SVD vs MVD patients, respectively. The cumulative incidence of MACE during 12-month follow-up was significantly higher in patients with MVD (32.5% vs 14.5%, p 〈 0.0001). Moreover, multivariate analysis revealed that after a correction for baseline differences, the presence of MVD was a strong and independent predictor for five-year mortality in patients treated with PCI (hazard ratio 1.45, 95% confidence interval 1.13-1.88, p = 0.004).
  
  
  CONCLUSIONS
  The presence of MVD in patients with STEMI is a strong and independent risk factor for higher long-term mortality.
authors.affiliation: 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lekston
authors.forename: Mateusz
authors.initials: M
authors.lastname: Tajstra
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gąsior
authors.forename: Marek
authors.initials: M
authors.lastname: Gierlotka
authors.forename: Damian
authors.initials: D
authors.lastname: Pres
authors.forename: Bartosz
authors.initials: B
authors.lastname: Hudzik
authors.forename: Przemysław
authors.initials: P
authors.lastname: Trzeciak
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kalarus
authors.forename: Lech
authors.initials: L
authors.lastname: Poloński
authors.forename: Marian
authors.initials: M
authors.lastname: Zembala
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D011044:Poland / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome