Effect of revascularization strategy in patients with acute myocardial infarction and renal insufficiency with multivessel disease.
10.3904/kjim.2015.30.2.177
- Author:
Hyukjin PARK
1
;
Young Joon HONG
;
Si Hyun RHEW
;
Sung Soo KIM
;
Young Wook JEONG
;
Hae Chang JEONG
;
Jae Yeong CHO
;
Soo Young JANG
;
Ki Hong LEE
;
Keun Ho PARK
;
Doo Sun SIM
;
Nam Sik YOON
;
Hyun Ju YOON
;
Kye Hun KIM
;
Hyung Wook PARK
;
Ju Han KIM
;
Youngkeun AHN
;
Myung Ho JEONG
;
Jeong Gwan CHO
;
Jong Chun PARK
Author Information
1. Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea. hyj200@hanmail.net
- Publication Type:Original Article ; Comparative Study ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
- Keywords:
Myocardial infarction;
Percutaneous coronary intervention;
Glomerular filtration rate
- MeSH:
Aged;
Aged, 80 and over;
Coronary Artery Disease/complications/diagnosis/mortality/*therapy;
Female;
Glomerular Filtration Rate;
Hospital Mortality;
Humans;
Kaplan-Meier Estimate;
Kidney/physiopathology;
Male;
Middle Aged;
Myocardial Infarction/complications/diagnosis/mortality/*therapy;
Percutaneous Coronary Intervention/adverse effects/*methods/mortality;
Prospective Studies;
Recurrence;
Registries;
Renal Insufficiency/diagnosis/*etiology/mortality/physiopathology;
Republic of Korea;
Risk Factors;
Time Factors;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2015;30(2):177-190
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The aim of this study was to compare the risk of complications and outcome between infarct-related artery (IRA)-only revascularization and multivessel (MV) revascularization in patients with acute myocardial infarction (MI) with renal insufficiency and MV disease. METHODS: A total of 1,031 acute MI patients with renal insufficiency and MV disease who were registered in the Korea Working Group on Myocardial Infarction were enrolled. They were divided into two groups (IRA-only revascularization group, n = 404; MV revascularization group, n = 627), and investigated the cumulative incidence of major adverse cardiac events (MACE) and the incidence of complications after percutaneous coronary intervention (PCI). RESULTS: Complications after PCI occurred in 19.9% of all patients (206/1,031). Complications after PCI occurred more frequently in the MV revascularization group compared with the IRA-only revascularization group (20.1% [126/627] vs. 15.3% [62/404], respectively; p = 0.029]. The overall in-hospital mortality rate was 6.3%, and there was no significant difference between the groups (5.2% in the IRA-only revascularization group vs. 7.0% in the MV revascularization group; p = 0.241). The total incidence of MACE was 11.1%, and there was no significant difference between the groups (11.6% in the IRA-only revascularization group vs. 10.7% in the MV revascularization group; p = 0.636). CONCLUSIONS: The incidence of complications after PCI was significantly lower in the IRA-only revascularization group compared with the MV revascularization group. However, there were no significant difference in the 12-month outcomes between groups in patients with acute MI and renal insufficiency with MV disease.
