title: Prognosis of STEMI Patients with Multi-Vessel Disease Undergoing Culprit-Only PCI without Significant Residual Ischemia on Non-Invasive Stress Testing.
abstract: OBJECTIVE
  In about 50-80% of ST-segment elevation myocardial infarction (STEMI) patients there is significant atherosclerotic disease in other coronary arteries in addition to the culprit vessel. There is substantial controversy as to the optimal revascularization approach in these patients. We sought to compare the outcomes of STEMI patients with multi-vessel disease (MVD) treated with culprit-only primary percutaneous coronary intervention (PPCI) without significant ischemia on subsequent non-invasive testing, to those of STEMI patients with single-vessel disease (SVD).
  
  
  RESULTS
  Between 2001-2010, 1,540 consecutive patients treated with primary PCI for STEMI were prospectively observed and entered into a comprehensive clinical database. The primary end point was a composite of major adverse cardiac events (MACE), consisting of mortality, re-infarction and revascularization within 1 and 3 years following PPCI (excluding events occurring during the first 30 days). Patients with cardiogenic shock were excluded. The study included 720 patients with SVD and 185 patients with MVD who underwent culprit-only PPCI and had no residual ischemia on subsequent non-invasive stress testing. Patients with MVD were older, more likely to have hypertension or previous MI and less likely to be smokers and present with anterior MI than patients with SVD. One and 3-year MACE rates were similar between the groups. On cox proportional-hazards regression MVD without residual ischemia was not independently associated with MACE and its components.
  
  
  CONCLUSIONS
  STEMI patients with MVD treated with culprit only-PCI without significant residual ischemia on non-invasive stress testing appear to have similar prognosis to STEMI patients with SVD.
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel.
authors.forename: Adaya
authors.initials: A
authors.lastname: Weissler-Snir
authors.affiliation: The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Chen
authors.initials: C
authors.lastname: Gurevitz
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Abid
authors.initials: A
authors.lastname: Assali
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel.
authors.forename: Hana
authors.initials: H
authors.lastname: Vaknin-Assa
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel.
authors.forename: Tamir
authors.initials: T
authors.lastname: Bental
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel.
authors.forename: Adi
authors.initials: A
authors.lastname: Lador
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel.
authors.forename: Hagai
authors.initials: H
authors.lastname: Yavin
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Leor
authors.initials: L
authors.lastname: Perl
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
authors.affiliation: Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Lev
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000503:physiopathology / Q000601:surgery*