Comparison of clinical outcomes between culprit vessel only and multivessel percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel coronary diseasesopen access
- Authors
- Ryu, Kwang Sun; Park, Hyun Woo; Park, Soo Ho; Shon, Ho Sun; Ryu, Keun Ho; Lee, Dong Gyu; Bashir, Mohamed E.A.; Lee, Ju Hee; Kim, Sang Min; Lee, Sang Yeub; Bae, Jang Whan; Hwang, Kyung Kuk; Kim, Dong Woon; Cho, Myeong Chan; Ahn, Young Keun; Jeong, Myung Ho; Kim, Chong Jin; Park, Jong Seon; Kim, Young Jo; Jang, Yang Soo; Kim, Hyo Soo; Seung, Ki Bae
- Issue Date
- May-2015
- Publisher
- Science Press
- Keywords
- Culprit only intervention; Multivessel coronary disease; Multivessel intervention; Myocardial infarction; Primary percutaneous coronary intervention
- Citation
- Journal of Geriatric Cardiology, v.12, no.3, pp 208 - 217
- Pages
- 10
- Journal Title
- Journal of Geriatric Cardiology
- Volume
- 12
- Number
- 3
- Start Page
- 208
- End Page
- 217
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/75343
- DOI
- 10.11909/j.issn.1671-5411.2015.03.014
- ISSN
- 1671-5411
- Abstract
- Background: The clinical significance of complete revascularization for ST segment elevation myocardial infarction (STEMI) patients during admission is still debatable. Methods: A total of 1406 STEMI patients from the Korean Myocardial Infarction Registry with multivessel diseases without cardiogenic shock who underwent primary percutaneous coronary intervention (PPCI) were analyzed. We used propensity score matching (PSM) to control differences of baseline characteristics between culprit only intervention (CP) and multivessel percutaneous coronary interventions (MP), and between double vessel disease (DVD) and triple vessel disease (TVD). The major adverse cardiac event (MACE) was analyzed for one year after discharge. Results: TVD patients showed higher incidence of MACE (14.2% vs. 8.6%, P = 0.01), any cause of revascularization (10.6% vs. 5.9%, P = 0.01), and repeated PCI (9.5% vs. 5.7%, P = 0.02), as compared to DVD patients during one year after discharge. MP reduced MACE effectively (7.3% vs. 13.8%, P = 0.03), as compared to CP for one year, but all cause of death (1.6% vs. 3.2%, P = 0.38), MI (0.4% vs. 0.8%, P = 1.00), and any cause of revascularization (5.3% vs. 9.7%, P = 0.09) were comparable in the two treatment groups. Conclusions: STEMI patients with TVD showed higher rate of MACE, as compared to DVD. MP performed during PPCI or ad hoc during admission for STEMI patients without cardiogenic shock showed lower rate of MACE in this large scaled database. Therefore, MP could be considered as an effective treatment option for STEMI patients without cardiogenic shock. ©2015 JGC All rights reserved.
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