1.Comparison of clinical outcomes between culprit vessel only and multivessel percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel coronary diseases
Ryu Sun Kwang ; Park Woo Hyun ; Park Ho Soo ; Shon Sun Ho ; Ryu Ho Keun ; Lee Gyu Dong ; Bashir EA Mohamed ; Lee Hee Ju ; Kim Min Sang ; Lee Yeub Sang ; Bae Whan Jang ; Hwang Kuk Kyung ; Kim Woon Dong ; Cho Chan Myeong ; Ahn Keun Young ; Jeong Ho Myung ; Kim Jin Chong ; P
Journal of Geriatric Cardiology 2015;(3):208-217
Background The clinical significance of complete revascularization for ST segment elevation myocardial infarction (STEMI) pa-tients 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.
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