title: Culprit-Lesion-Only Versus Multivessel Revascularization Using Drug-Eluting Stents in Patients With ST-Segment Elevation Myocardial Infarction: A Korean Acute Myocardial Infarction Registry-Based Analysis.
abstract: OBJECTIVE
  In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization (CR) for non-culprit lesions is not routinely recommended. The aim of this study was to compare the clinical outcomes of multivessel compared with infarct-related artery (IRA)-only revascularization in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI.
  
  
  METHODS
  From the Korean Acute Myocardial Infarction Registry (KAMIR) database, 1,094 STEMI patients with multivessel disease who underwent primary PCI with drug-eluting stents were enrolled in this study. The patients were divided into two groups: culprit-vessel-only revascularization (COR, n=827) group; multivessel revascularization, including non-IRA (MVR, n=267) group. The primary endpoint of this study included major adverse cardiac events (MACEs), such as death, myocardial infarction, or target or nontarget lesion revascularization at one year.
  
  
  RESULTS
  There was no difference in clinical characteristics between the two groups. During the one-year follow-up, 102 (15.2%) patients in the COR group and 32 (14.2%) in the MVR group experienced at least one MACE (p=0.330). There were no differences between the two groups in terms of rates of death, myocardial infarction, or revascularization (2.1% vs. 2.0%, 0.7% vs. 0.8%, and 11.7% vs. 10.1%, respectively; p=0.822, 0.910, and 0.301, respectively). The MACE rate was higher in the incompletely revascularized patients than in the completely revascularized patients (15% vs. 9.5%, p=0.039), and the difference was attributable to a higher rate of nontarget vessel revascularization (8.6% vs. 1.8%, p=0.002).
  
  
  CONCLUSIONS
  Although multivessel angioplasty during primary PCI for STEMI did not reduce the MACE rate compared with culprit-vessel-only PCI, CR was associated with a lower rate of repeat revascularization after multivessel PCI.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
authors.forename: Hyun Su
authors.initials: HS
authors.lastname: Jo
authors.forename: Jong Seon
authors.initials: JS
authors.lastname: Park
authors.forename: Jang Won
authors.initials: JW
authors.lastname: Sohn
authors.forename: Joon Cheol
authors.initials: JC
authors.lastname: Yoon
authors.forename: Chang Woo
authors.initials: CW
authors.lastname: Sohn
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Lee
authors.forename: Geu Ru
authors.initials: GR
authors.lastname: Hong
authors.forename: Dong Gu
authors.initials: DG
authors.lastname: Shin
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Jei Keon
authors.initials: JK
authors.lastname: Chae
authors.forename: Jay Young
authors.initials: JY
authors.lastname: Rhew
authors.forename: In Ho
authors.initials: IH
authors.lastname: Chae
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Bae
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Choi
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Yoon
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Seung Jung
authors.initials: SJ
authors.lastname: Park