Stratagy and prognosis of managing culprit vessel with two lesions undergoing primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction
10.3969/j.issn.1004-8812.2018.05.002
- VernacularTitle:急性ST段抬高型心肌梗死患者靶血管非梗死相关病变处理策略选择及预后
- Author:
Zhan-Chun CONG
1
;
Xin ZHAO
;
Quan-Min JING
Author Information
1. 沈阳军区总医院心血管内科
- Keywords:
ST-segment elevation myocardial infarction;
Target vessel;
Non-infarct related lesions;
Percutaneous coronary intervention
- From:
Chinese Journal of Interventional Cardiology
2018;26(5):247-254
- CountryChina
- Language:Chinese
-
Abstract:
Objective To asess the primary percutaneous coronary intervention(PPCI) strategies of culprit vessel with two lesions in ST-segment elevation myocardial infarction(STEMI) patients and their prognosis.Methods The study retrospectively reviewed 418 patients with STEMI undergoing PPCI in the General Hospital of Shenyang Military Region from January 1st to June 30th in 2015 and 75 patients were included. According to whether the non-infarct-related lesions(N-IRL) being treated or not,the patients were identified as both IRL and N-IRL being treated(the research group,n=33) or the culprit lesion(or infarct-related lesion,IRL) being treated only(control group,n=42). The endpoint was major adverse cardiocascular event(MACE) which was a composite of death from cardiac causes,nonfatal myocardial infarction,target vessel revascularization(TVR) and hospitalization with angina or heart failure.Results The study endpoint betwwen the two groups showed no statistical differences in MACE(P=0.446). Multivariate Cox regression analysis showed that age, diameter of N-IRL were predictive factors of MACE. When N-IRL located beyond the culprit lesion, the research group showed higher risk of MACE(P=0.022) and TVR(P=0.039).Conclusions The non-infarct-related lesions of patients with STEMI undergoing PPCI may be left for conventional medical treatment. It may be reasonable to choose drug therapy for distal N-IRL and to choose PCI for proximal N-IRL.
