title: Recurrent Myocardial Infarction After Primary Percutaneous Coronary Intervention in Multivessel Coronary Disease Is Primarily Related to Stent Failure: Post-Hoc Analysis of the PASSION Trial.
abstract: OBJECTIVE
  Our aim was to investigate the risk of events related to non-culprit lesions after primary percutaneous coronary intervention (PCI) in patients with multivessel coronary disease (MVD).
  
  
  BACKGROUND
  In patients undergoing primary PCI for ST-elevation myocardial infarction (STEMI) who are diagnosed with MVD, the optimal treatment strategy is currently under debate. Although observational data exposed an increased risk of multivessel PCI in the acute phase of STEMI, 2 recently published randomized controlled trials showed a reduction of death or recurrent myocardial infarction (MI) after preventive PCI of non-culprit lesions when compared with culprit-lesion PCI only.
  
  
  METHODS
  We performed a post-hoc analysis of 279 patients with MVD included in the Paclitaxel-Eluting Stent versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation (PASSION) trial. We analyzed the incidence and cause of recurrent MI. Recurrent MI due to stent failure was assumed in the event of definite or probable stent thrombosis.
  
  
  RESULTS
  After 5 years, 14 patients (5.7%) with MVD had a recurrent MI versus 17 (5.4%) patients with 1-vessel disease (HR 1.06, 95%CI 0.52-2.15, P = 0.87). The majority of events was attributable to stent failure, while of the remaining 6 events, only 1 was proven to originate from a lesion that was judged significant at enrolment.
  
  
  CONCLUSIONS
  In this post-hoc analysis of the PASSION trial, recurrent MI in patients with MVD was mainly related to stent failure rather than a new event originating from a significant stenosis in a non-culprit coronary artery.
authors.affiliation: Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Maarten A
authors.initials: MA
authors.lastname: Vink
authors.affiliation: Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Nicola S
authors.initials: NS
authors.lastname: Vos
authors.affiliation: Medisch Centrum Alkmaar, Alkmaar, The Netherlands.
authors.forename: Maurits T
authors.initials: MT
authors.lastname: Dirksen
authors.affiliation: St Antonius Ziekenhuis, Nieuwegein, The Netherlands.
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Suttorp
authors.affiliation: Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Ton
authors.initials: T
authors.lastname: Slagboom
authors.affiliation: Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Patterson
authors.affiliation: Tergooi, Blaricum, The Netherlands.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Kiemeneij
authors.affiliation: Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
authors.forename: GertJan
authors.initials: G
authors.lastname: Laarman
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000628:therapy*; D054855:Drug-Eluting Stents; D004868:Equipment Failure; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy; D017239:Paclitaxel; D062645:Percutaneous Coronary Intervention; D012008:Recurrence
chemical_list: D017239:Paclitaxel