Comparison of clinical outcomes between culprit vessel only and multivessel percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel coronary diseases

Title
Comparison of clinical outcomes between culprit vessel only and multivessel percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel coronary diseases
Author(s)
류광순[류광순]박현우[박현우]손호선[손호선]류근호[류근호]이동규[이동규]Mohamed EA Bashir[Mohamed EA Bashir]이주희[이주희]김상민[김상민]이상엽[이상엽]배장환[배장환]황경국[황경국]김동훈[김동훈]조명찬[조명찬]안영근[안영근]정명호[정명호]김종진[김종진]박종선김영조장양수[장양수]김효수[김효수]승기배[승기배]
Keywords
DRUG-ELUTING-STENTS; TERM-FOLLOW-UP; ANGIOPLASTY; REGISTRY; SAFETY
Issue Date
201507
Publisher
SCIENCE PRESS
Citation
JOURNAL OF GERIATRIC CARDIOLOGY, v.12, no.3, pp.208 - 217
Abstract
Background The clinical significance of complete revascularization for ST segment elevation myocardial infarction (STEMI) patients 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.
URI
http://hdl.handle.net/YU.REPOSITORY/31653
ISSN
1671-5411
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의과대학 > 내과학교실 > Articles
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