title: Culprit vessel versus multivessel intervention at the time of primary percutaneous coronary intervention in patients with ST-segment-elevation myocardial infarction and multivessel disease: real-world analysis of 3984 patients in London.
abstract: BACKGROUND
  It is estimated that up to two thirds of patients presenting with ST-segment-elevation myocardial infarction have multivessel disease. The optimal strategy for treating nonculprit disease is currently under debate. This study provides a real-world analysis comparing a strategy of culprit-vessel intervention (CVI) versus multivessel intervention at the time of primary percutaneous coronary intervention in patients with ST-segment-elevation myocardial infarction.
  
  
  RESULTS
  We compared CVI versus multivessel intervention in 3984 patients with multivessel disease undergoing primary percutaneous coronary intervention between 2004 and 2011 at all 8 tertiary cardiac centers in London. Multivariable-adjusted models were built to determine independent predictors for in-hospital major adverse cardiovascular events (MACEs) and all-cause mortality at 1 year. To reduce confounding and bias, propensity score methods were used. CVI was associated with reduced in-hospital MACE (4.6% versus 7.2%; P=0.010) and mortality at 1 year (7.4% versus 10.1%; P=0.031). CVI was an independent predictor for reduced in-hospital MACE (odds ratio, 0.49; 95% confidence interval [CI], 0.32-0.75; P<0.001) and survival at 1 year (hazard ratio, 0.65; 95% CI, 0.47-0.91; P=0.011) in the complete cohort; and in 2821 patients in propensity-matched cohort (in-hospital MACE: odds ratio, 0.49; 95% CI, 0.32-0.76; P=0.002; and 1-year survival: hazard ratio, 0.64; 95% CI, 0.45-0.90; P=0.010). Inverse probability treatment weighted analyses also confirmed CVI as an independent predictor for reduced in-hospital MACE (odds ratio, 0.38; 95% CI, 0.15-0.96; P=0.040) and survival at 1 year (hazard ratio, 0.44; 95% CI, 0.21-0.93; P=0.033).
  
  
  CONCLUSIONS
  In this observational analysis of patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention, CVI was associated with increased survival at 1 year. Acknowledging the limitations with observational analyses, our findings support current recommended practice guidelines.
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.). b.iqbal@imperial.ac.uk.
authors.forename: M Bilal
authors.initials: MB
authors.lastname: Iqbal
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Charles
authors.initials: C
authors.lastname: Ilsley
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Tito
authors.initials: T
authors.lastname: Kabir
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Robert
authors.initials: R
authors.lastname: Smith
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lane
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Mark
authors.initials: M
authors.lastname: Mason
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Piers
authors.initials: P
authors.lastname: Clifford
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Tom
authors.initials: T
authors.lastname: Crake
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Sam
authors.initials: S
authors.lastname: Firoozi
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Sundeep
authors.initials: S
authors.lastname: Kalra
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Charles
authors.initials: C
authors.lastname: Knight
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Pitt
authors.initials: P
authors.lastname: Lim
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Iqbal S
authors.initials: IS
authors.lastname: Malik
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Anthony
authors.initials: A
authors.lastname: Mathur
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Pascal
authors.initials: P
authors.lastname: Meier
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Roby D
authors.initials: RD
authors.lastname: Rakhit
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Simon
authors.initials: S
authors.lastname: Redwood
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Mark
authors.initials: M
authors.lastname: Whitbread
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Dan
authors.initials: D
authors.lastname: Bromage
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Krishna
authors.initials: K
authors.lastname: Rathod
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Philip
authors.initials: P
authors.lastname: MacCarthy
authors.affiliation: From the Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Middlesex, United Kingdom (M.B.I., C.I., T.K., R.S., R.L., M.M., P.C., M.D.); Department of Cardiology, UCL Hospitals NHS Foundation Trust, Heart Hospital, London, United Kingdom (T.C., P. Meier); Department of Cardiology, King's College Hospital NHS Foundation Trust, London, United Kingdom (S.K., P. MacCarthy); Department of Cardiology, Barts Health NHS Trust, The London Chest Hospital, London, United Kingdom (C.K., A.M., D.B., K.R.); Department of Cardiology, St. George's Healthcare NHS Foundation Trust, St. George's Hospital, London, United Kingdom (S.F., P.L.); Department of Cardiology, Imperial College Healthcare NHS Foundation Trust, Hammersmith Hospital, London, United Kingdom (I.S.M.); Department of Cardiology, Royal Free London NHS Foundation Trust, London, United Kingdom (R.D.R.); Department of Cardiology, BHF Centre of Excellence, King's College London, St. Thomas Hospital, London, United Kingdom (S.R.); and Department of Cardiology, London Ambulance Service, London, United Kingdom (M.W.).
authors.forename: Miles
authors.initials: M
authors.lastname: Dalby
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery; D004562:Electrocardiography; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D008131:London / Q000453:epidemiology; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D057216:Propensity Score; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: ST-segment elevation myocardial infarction; culprit artery; multivessel percutaneous coronary intervention; primary percutaneous coronary intervention