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.
10.4070/kcj.2011.41.12.718
- Author:
Hyun Su JO
1
;
Jong Seon PARK
;
Jang Won SOHN
;
Joon Cheol YOON
;
Chang Woo SOHN
;
Sang Hee LEE
;
Geu Ru HONG
;
Dong Gu SHIN
;
Young Jo KIM
;
Myung Ho JEONG
;
Shung Chull CHAE
;
Seung Ho HUR
;
Taek Jong HONG
;
In Whan SEONG
;
Jei Keon CHAE
;
Jay Young RHEW
;
In Ho CHAE
;
Myeong Chan CHO
;
Jang Ho BAE
;
Seung Woon RHA
;
Chong Jin KIM
;
Dong Hoon CHOI
;
Yang Soo JANG
;
Jung Han YOON
;
Wook Sung CHUNG
;
Ki Bae SEUNG
;
Seung Jung PARK
Author Information
1. Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea. pjs@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Coronary artery disease;
Angioplasty
- MeSH:
Angioplasty;
Arteries;
Coronary Artery Disease;
Drug-Eluting Stents;
Follow-Up Studies;
Glycosaminoglycans;
Humans;
Myocardial Infarction;
Percutaneous Coronary Intervention
- From:Korean Circulation Journal
2011;41(12):718-725
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
