Culprit-Lesion-Only Versus Multivessel Revascularization Using Drug-Eluting Stents in Patients With ST-Segment Elevation Myocardial Infarction: A Korean Acute Myocardial Infarction Registry-Based Analysis

BACKGROUND AND OBJECTIVES: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization (CR) for non-culprit lesions is not routinely recommended. The aim of this study was to compare the clinical outcomes of multivessel compared with infarc...

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Detalles Bibliográficos
Autores principales: Jo, Hyun Su, Park, Jong Seon, Sohn, Jang Won, Yoon, Joon Cheol, Sohn, Chang Woo, Lee, Sang Hee, Hong, Geu Ru, Shin, Dong Gu, Kim, Young Jo, Jeong, Myung Ho, Chae, Shung Chull, Hur, Seung Ho, Hong, Taek Jong, Seong, In Whan, Chae, Jei Keon, Rhew, Jay Young, Chae, In Ho, Cho, Myeong Chan, Bae, Jang Ho, Rha, Seung Woon, Kim, Chong Jin, Choi, Dong Hoon, Jang, Yang Soo, Yoon, Jung Han, Chung, Wook Sung, Seung, Ki Bae, Park, Seung Jung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2011
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257455/
https://www.ncbi.nlm.nih.gov/pubmed/22259602
http://dx.doi.org/10.4070/kcj.2011.41.12.718
Descripción
Sumario:BACKGROUND AND OBJECTIVES: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization (CR) for non-culprit lesions is not routinely recommended. The aim of this study was to compare the clinical outcomes of multivessel compared with infarct-related artery (IRA)-only revascularization in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI. SUBJECTS AND METHODS: From the Korean Acute Myocardial Infarction Registry (KAMIR) database, 1,094 STEMI patients with multivessel disease who underwent primary PCI with drug-eluting stents were enrolled in this study. The patients were divided into two groups: culprit-vessel-only revascularization (COR, n=827) group; multivessel revascularization, including non-IRA (MVR, n=267) group. The primary endpoint of this study included major adverse cardiac events (MACEs), such as death, myocardial infarction, or target or nontarget lesion revascularization at one year. RESULTS: There was no difference in clinical characteristics between the two groups. During the one-year follow-up, 102 (15.2%) patients in the COR group and 32 (14.2%) in the MVR group experienced at least one MACE (p=0.330). There were no differences between the two groups in terms of rates of death, myocardial infarction, or revascularization (2.1% vs. 2.0%, 0.7% vs. 0.8%, and 11.7% vs. 10.1%, respectively; p=0.822, 0.910, and 0.301, respectively). The MACE rate was higher in the incompletely revascularized patients than in the completely revascularized patients (15% vs. 9.5%, p=0.039), and the difference was attributable to a higher rate of nontarget vessel revascularization (8.6% vs. 1.8%, p=0.002). CONCLUSION: Although multivessel angioplasty during primary PCI for STEMI did not reduce the MACE rate compared with culprit-vessel-only PCI, CR was associated with a lower rate of repeat revascularization after multivessel PCI.

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