title: Prognostic importance of the extent of coronary revascularisation in patients with acute coronary syndromes and multivessel disease: one-year prospective follow-up.
abstract: BACKGROUND
  Interventional treatment improves prognosis in patients with acute coronary syndromes (ACS). However, despite introduction of percutaneous coronary intervention (PCI), the risk of cardiovascular events in patients with multivessel coronary artery disease (MVD) remains significant.
  
  
  OBJECTIVE
  To evaluate the risk of complications and the prognostic value of MVD in patients with ACS during 1-year follow-up.
  
  
  METHODS
  A group of 153 patients with ACS was followed up at a single cardiology unit with round-the-clock PCI capability. Treatment of ACS, the extent of revascularisation, and complications occurring during hospitalisation and 1-year follow-up were analysed. The end points of the study were defined as death from all causes, cardiac death, recurrent ACS and a composite end point (deaths from cardiac causes and recurrent ACS).
  
  
  RESULTS
  During 1-year follow-up, 11 (7.2%) patients died, including 10 patients with MVD without complete revascularisation. Recurrent ACS occurred in 18 (12%) patients, including 13 patients with MVD without complete revascularisation. Presence of a residual significant coronary stenosis in incompletely revascularised patients with MVD was an important risk factor for all-cause mortality and occurrence of a composite endpoint in comparison to MVD patients who underwent complete revascularisation (p = 0.028 and p = 0.046, respectively) and patients with single-vessel disease (p = 0.006 and p = 0.003, respectively).
  
  
  CONCLUSIONS
  Incomplete revascularisation during the acute phase of ACS was associated with an increased risk of complications and a significantly increased risk of all-cause mortality and the combined rate of cardiovascular deaths and recurrent ACS. Single-stage PCI of all significant stenoses in MVD patients resulted in better outcomes.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Łuczak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Majda
authors.affiliation: Instytut Kardiologii Warszawa. rdabrowski45@gmail.com.
authors.forename: Rafał
authors.initials: R
authors.lastname: Dąbrowski
authors.forename: Ilona
authors.initials: I
authors.lastname: Kowalik
authors.forename: Sławomir
authors.initials: S
authors.lastname: Jasek
authors.forename: Cezary
authors.initials: C
authors.lastname: Sosnowski
authors.forename: Marek
authors.initials: M
authors.lastname: Kośmicki
authors.forename: Anna
authors.initials: A
authors.lastname: Mazurkiewicz
authors.forename: Hanna
authors.initials: H
authors.lastname: Szwed
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000368:Aged; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012307:Risk Factors