Multivessel percutaneous coronary intervention in patients with acute myocardial infarction and severe renal dysfunction
- Authors
- Song, Pil Sang; Hahn, Joo-Yong; Gwon, Hyeon-Cheol; Jeon, Ki-Hyun; Yu, Cheol Woong; Rha, Seung-Woon; Yoon, Chang-Hwan; Jeong, Myung Ho
- Issue Date
- 12월-2019
- Publisher
- EUROPA EDITION
- Keywords
- multiple vessel disease; non-STEMI; renal insufficiency; STEMI
- Citation
- EUROINTERVENTION, v.15, no.11, pp.E1014 - +
- Indexed
- SCIE
SCOPUS
- Journal Title
- EUROINTERVENTION
- Volume
- 15
- Number
- 11
- Start Page
- E1014
- End Page
- +
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/61366
- DOI
- 10.4244/EIJ-D-19-00034
- ISSN
- 1774-024X
- Abstract
- Aims: The aim of this study was to compare the outcomes between multivessel and infarct-related artery (IRA)-only percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), multivessel disease (MVD), and severe renal dysfunction (RD) using the nationwide AMI registry. Methods and results: Among 13,104 patients, 537 diagnosed with AMI and MVD who had severe RD at presentation (estimated glomerular filtration rate [GFR] <30 mL/min/1.73 m2, mean: 19.1 +/- 7.5 mL/min/1.73 m2) and underwent PCI during index hospitalisation were selected. The patients were classified according to treatment strategy, i.e., multivessel PCI (49.0%) or IRA-only PCI. The primary endpoint was major adverse cardiac events (MACE), a composite of all-cause death, myocardial reinfarction, re-hospitalisation for heart failure, and any repeat revascularisation at one year. The safety outcome was the worsening of renal function (WRF), defined as a 30% reduction in estimated GFR from baseline to 12-month follow-up. The adjusted MACE risks were similar in groups after Cox regression (41.8% vs 39.8%, hazard ratio [HR] 1.008 [0.743-1.367]) and propensity score-matching analysis (HR 0.974 [0.651-1.377]). Multivessel PCI showed a significant tendency of higher rates of WRF (24.8% vs 11.1%, adjusted odds ratio 2.134 [0.976-4.668]). Conclusions: Multivessel PCI was associated with similar outcomes compared to IRA-only PCI in patients with AMI, MVD, and severe RD.
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- Appears in
Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
- Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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