Original articles |
Multivessel Coronary Disease in ST-Elevation Myocardial Infarction: Three Different Revascularization Strategies and Long-Term Outcomes
1 Institute of Cardiology, Policlinico University Hospital, Modena, Italy
* To whom correspondence should be addressed. E-mail: luigi.politi{at}unimore.it.
Accepted 25 August 2009
Abstract
Background: Few reports described outcomes of complete compared with infarct related artery (IRA) only revascularization in patients with ST elevation myocardial infarction (STEMI) and multivessel coronary disease (CAD). Moreover there are no studies comparing simultaneous treatment of non-IRAs with the IRA treatment followed by elective procedure for the other lesions (staged revascularization).
Methods: We studied the outcomes of 214 consecutive patients with STEMI and multivessel CAD undergoing primary angioplasty. Before the first angioplasty patients were randomized to 3 different strategies: 1) culprit vessel angioplasty only (COR group), 2) staged revascularization (SR group), and 3) simultaneous treatment of non-IRAs (CR group).
Results: During a mean follow-up of 2.5 years, 42 (50.0%) patients in COR group experienced at least one major adverse cardiac event (MACE), 13 (20.0%) in SR group, and 15 (23.1%) in CR group, p<0.001. In-hospital death, repeat revascularization and re-hospitalization occurred more frequently in COR group (all p<0.05), while there was no significant difference in re-infarction among the 3 groups. Survival free of MACE was significantly reduced in COR group but it was similar in CR and SR groups.
Conclusions: Culprit vessel only angioplasty was associated with the highest rate of long-term MACE as compared to multivessel treatment. Patients scheduled for staged revascularization experienced a similar rate of MACE as patients undergoing complete simultaneous treatment of non-IRAs.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text (Rapid PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
Google Scholar
PubMed
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
