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

Title
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
Author(s)
박종선조현수[조현수]손장원윤준철[윤준철]손창우[손창우]이상희홍그루신동구김영조정명호[정명호]채성철[채성철]허승호[허승호]홍택종[홍택종]성인환[성인환]채재건[채재건]류재영[류재영]채인호[채인호]조명찬[조명찬]배장호[배장호]라승운[라승운]김종진[김종진]최동훈[최동훈]장양수[장양수]윤정한[윤정한]정욱성[정욱성]승기배[승기배]박승정[박승정]
Keywords
Myocardial infarction; Coronary artery disease; Angioplasty.
Issue Date
201112
Publisher
대한심장학회
Citation
Korean Circulation Journal, v.41, no.12, pp.718 - 725
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.
URI
http://hdl.handle.net/YU.REPOSITORY/24100
ISSN
1738-5520
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의과대학 > 내과학교실 > Articles
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