open access

Vol 19, No 3 (2012)
Original articles
Published online: 2012-05-28
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Comparison of infarct-related artery vs multivessel revascularization in ST-segment elevation myocardial infarction with multivessel disease: Analysis from Korea Acute Myocardial Infarction Registry

Hye Won Lee, Taek Jong Hong, Mi Jin Yang, Sung Gyu An, Jun-Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Kwang Soo Cha, Ju Young Hong; Korea Acute Myocardial In Investigators
Cardiol J 2012;19(3):256-266.

open access

Vol 19, No 3 (2012)
Original articles
Published online: 2012-05-28

Abstract

Background: Many ST-segment elevation myocardial infarction (STEMI) patients have multivessel disease. There is still controversy in treatment strategy in STEMI patients with multivessel disease. We compared clinical outcomes of multivessel revascularization with infarct- related artery (IRA) revascularization in STEMI patients.
Methods: The 1,644 STEMI patients with multivessel disease (1,106 in IRA group, 538 in multivessel group) who were received primary percutaneous coronary intervention (PCI) were analyzed from a nationwide Korea Acute Myocardial Infarction Registry. Primary endpoint was 12-month major adverse cardiac events (MACE, defined as death, myocardial infarction, and repeated revascularization). Secondary endpoints were 1-month MACE and each component, stent thrombosis during 12 month follow-up, and each components of the 12-month MACE.
Results: There were more patients with unfavorable baseline conditions in IRA group. 12-month MACE occurred in 165 (14.9%) patients in IRA group, 81 (15.1%) patients in multivessel group (p = 0.953). There were no statistical significance in the rate of 1-month MACE, each components of 1-month MACE, and stent thrombosis during 12 month follow-up. Each components of 12-month MACE were occurred similarly in both groups except for target lesion revascularization (2.4% in IRA group vs 5.9% in multivessel group, p < 0.0001). After adjusting for confounding factors, multivessel revascularization was not associated with reduced 12-month MACE (OR 1.096, 95% CI 0.676–1.775, p = 0.711).
Conclusions: There were no significant differences in clinical outcomes between both groups except for high risk of target lesion revascularization in multivessel revascularization group.

Abstract

Background: Many ST-segment elevation myocardial infarction (STEMI) patients have multivessel disease. There is still controversy in treatment strategy in STEMI patients with multivessel disease. We compared clinical outcomes of multivessel revascularization with infarct- related artery (IRA) revascularization in STEMI patients.
Methods: The 1,644 STEMI patients with multivessel disease (1,106 in IRA group, 538 in multivessel group) who were received primary percutaneous coronary intervention (PCI) were analyzed from a nationwide Korea Acute Myocardial Infarction Registry. Primary endpoint was 12-month major adverse cardiac events (MACE, defined as death, myocardial infarction, and repeated revascularization). Secondary endpoints were 1-month MACE and each component, stent thrombosis during 12 month follow-up, and each components of the 12-month MACE.
Results: There were more patients with unfavorable baseline conditions in IRA group. 12-month MACE occurred in 165 (14.9%) patients in IRA group, 81 (15.1%) patients in multivessel group (p = 0.953). There were no statistical significance in the rate of 1-month MACE, each components of 1-month MACE, and stent thrombosis during 12 month follow-up. Each components of 12-month MACE were occurred similarly in both groups except for target lesion revascularization (2.4% in IRA group vs 5.9% in multivessel group, p < 0.0001). After adjusting for confounding factors, multivessel revascularization was not associated with reduced 12-month MACE (OR 1.096, 95% CI 0.676–1.775, p = 0.711).
Conclusions: There were no significant differences in clinical outcomes between both groups except for high risk of target lesion revascularization in multivessel revascularization group.
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Keywords

myocardial infarction; coronary artery disease; percutaneous coronary intervention

About this article
Title

Comparison of infarct-related artery vs multivessel revascularization in ST-segment elevation myocardial infarction with multivessel disease: Analysis from Korea Acute Myocardial Infarction Registry

Journal

Cardiology Journal

Issue

Vol 19, No 3 (2012)

Pages

256-266

Published online

2012-05-28

Bibliographic record

Cardiol J 2012;19(3):256-266.

Keywords

myocardial infarction
coronary artery disease
percutaneous coronary intervention

Authors

Hye Won Lee
Taek Jong Hong
Mi Jin Yang
Sung Gyu An
Jun-Hyok Oh
Jung Hyun Choi
Han Cheol Lee
Kwang Soo Cha
Ju Young Hong; Korea Acute Myocardial In Investigators

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