Journal
CARDIOLOGY JOURNAL
Volume 19, Issue 3, Pages 256-266Publisher
VIA MEDICA
DOI: 10.5603/CJ.2012.0047
Keywords
myocardial infarction; coronary artery disease; percutaneous coronary intervention
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Funding
- Pusan National University
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Background: Many ST-segment elevation myocardial infarction (STEMI) patients have multivessel disease. There is still controversy in treatment strategy in STEMI patients with multi vessel disease. We compared clinical outcomes of multivessel revascularization with infarct-related artery (IRA) revascularization in STEMI patients. Methods: The 1,644 STEMI patients with multi vessel disease (1,106 in IRA grout., 538 in multivessel group) who were received primary percutaneous coronary intervention (PCI) were analyzed from a nationwide Korea Acute Myocardial Infarction Registry. Primary endpoint was 12-month major adverse cardiac events (MACE, defined as death, myocardial infarction, and repeated revascularization). Secondary endpoints were 1-month MACE and each component, stent thrombosis during 12 month follow-up, and each components of the 12-month MACE. Results: There were more patients with unfavorable baseline conditions in IRA group. 12-month MACE occurred in 165 (14.9%) patients in IRA group, 81(15.1%) patients in multivessel group (p = 0.953). There were no statistical significance in the rate of 1-month MACE, each components of 1-month MACE, and stent thrombosis during 12 month follow-up. Each components of 12-month MACE were occurred similarly in both groups except for target lesion revascularization (2.4% in IRA group vs 5.9% in multivessel group, p < 0.0001). After adjusting for confounding factors, rnultivessel revascularization was not associated with reduced 12-month MACE (OR 1.096, 95% CI 0.676-1.775, p = 0.711). Conclusions: There were no significant differences in clinical outcomes between both groups except for high risk of target lesion revascularization in multivessel revascularization group. (Cardiol J 2012; 19, 3: 256-266)
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