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

引用

Journal of Geriatric Cardiology 2015年第3期12卷 208-217页

作者： Kwang Sun Ryu Hyun Woo Park Soo Ho Park Ho Sun Shon Keun Ho Ryu Dong Gyu Lee Mohamed EA Bashir Ju Hee Lee Sang Min Kim Sang Yeub Lee Jang Whan Bae Kyung Kuk Hwang Dong Woon Kim Myeong Chan Cho Young Keun Ahn Myung Ho Jeong Chong Jin Kim Jong Seon Park Young Jo Kim Yang Soo Jang Hyo Soo Kim Ki Bae Seung Database and Bioinformatics Laboratory School of Electrical and Computer Engineering Chungbuk National University Cheongju Chungbuk South Korea Human Genome Center Institute of Medical Science University of Tokyo Minatoku Tokyo Japan Faculty of Computer Science and Information Technology University of Meddcal Sciences and Technology Khartoum Sudan Regional Curdiovcascular Disease Center Chungbuk National University Ho spital Cheonglu Chungbuk South Korea Division of Cardiology Department of Internal Medicine College of Medicine Chungbuk National University Cheongju Chungbuk South Korea Department of Cardiology Chonnam National University Hospital Donggu Gwangju South Korea Department of Internal Medicine Kyunghee University Gangdong Hospital Seoul South Korea Department of Internal Medicine Yeungnam University Hospital Medical Center Daegu South Korea Division of Cardiology Yonsei University Severance Hospital Seoul South Korea Cardiovascular Center and Department of Internal Medicine Seoul National University Hospital Seoul South Korea Department of Cardiovascular Medicine Catholic University St. Mary's Hospital Seoul South Korea

Background The clinical significance of complete revascularization for ST segment elevation myocardial infarction （STEMI） pa- tients 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）, Ml （0.4% vs. 0.8%, P = 1.00）, and any cause ofrevascularization （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.

关键词： culprit only intervention Multivessel intervention Multivessel coronary disease Myocardial infarction Primary percutaneous coronary intervention

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