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
- Authors
- Jo, Hyun Su; Park, Jong Seon; Sohn, Jang Won; Yoon, Joon Cheol; Sohn, Chang Woo; Lee, Sang Hee; Hong, Geu Ru; Shin, Dong Gu; Kim, Young Jo; Jeong, Myung Ho; Chae, Shung Chull; Hur, Seung Ho; Hong, Taek Jong; Seong, In Whan; Chae, Jei Keon; Rhew, Jay Young; Chae, In Ho; Cho, Myeong Chan; Bae, Jang Ho; Rha, Seung Woon; Kim, Chong Jin; Choi, Dong Hoon; Jang, Yang Soo; Yoon, Jung Han; Chung, Wook Sung; Seung, Ki Bae; Park, Seung Jung
- Issue Date
- 12월-2011
- Publisher
- KOREAN SOC CARDIOLOGY
- Keywords
- Myocardial infarction; Coronary artery disease; Angioplasty
- Citation
- KOREAN CIRCULATION JOURNAL, v.41, no.12, pp.718 - 725
- Indexed
- SCOPUS
KCI
- Journal Title
- KOREAN CIRCULATION JOURNAL
- Volume
- 41
- Number
- 12
- Start Page
- 718
- End Page
- 725
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/111069
- DOI
- 10.4070/kcj.2011.41.12.718
- ISSN
- 1738-5520
- 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.
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