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One-Year Clinical Outcomes between Single- versus Multi-Staged PCI for ST Elevation Myocardial ...
  • Date2021-02-23 17:57
  • Update2021-02-23 17:57
  • CountersignatureDivision of Research Planning
  • Tel043-719-8033

Korean Circulation Journal, 2020.50(3), 220-233, DOI: https://doi.org/10.4070/kcj.2019.0176


One-Year Clinical Outcomes between Single- versus Multi-Staged PCI for ST Elevation Myocardial Infarction with Multi-Vessel Coronary Artery Disease: from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH)

Kye Taek Ahn, Seok-Woo Seong; Seon-Ah Jin; Jae-Hwan Lee; Si Wan Choi; Myung Ho Jeong; Shung Chull Chae; Young Jo Kim; Chong Jin Kim; Hyo-Soo Kim; Myeong Chan Cho; Hyeon Cheol Gwon; Jin-Ok Jeong; In-Whan Seong


Abstract

    Background and objectives: Although complete revascularization is known superior to incomplete revascularization in ST elevation myocardial infarction (STEMI) patients with multi-vessel coronary artery disease (MVCD), there are no definite instructions on the optimal timing of non-culprit lesions percutaneous coronary intervention (PCI). We compared 1-year clinical outcomes between 2 different complete multi-vessel revascularization strategies.
    Methods: From the Korea Acute Myocardial Infarction Registry-National Institute of Health, 606 patients with STEMI and MVCD who underwent complete revascularization were enrolled from November 2011 to December 2015. The patients were assigned to multi-vessel single-staged PCI (SS PCI) group (n=254) or multi-vessel multi-staged PCI (MS PCI) group (n=352). Propensity score matched 1-year clinical outcomes were compared between the groups.
    Results: At one year, MS PCI showed a significantly lower rate of all-cause mortality (hazard ratio [HR], 0.42; 95% confidential interval [CI], 0.19-0.92; p=0.030) compared with SS PCI. In subgroup analysis, all-cause mortality increased in SS PCI with cardiogenic shock (HR, 4.60; 95% CI, 1.54-13.77; p=0.006), age ≥65 years (HR, 4.00; 95% CI, 1.67-9.58, p=0.002), Killip class III/IV (HR, 7.32; 95% CI, 1.68-31.87; p=0.008), and creatinine clearance ≤60 mL/min (HR, 2.81; 95% CI, 1.10-7.18; p=0.031). After propensity score-matching, MS PCI showed a significantly lower risk of major adverse cardiovascular event than SS PCI.
    Conclusions: SS PCI was associated with worse clinical outcomes compared with MS PCI. MS PCI for non-infarct-related artery could be a better option for patients with STEMI and MVCD, especially high-risk patients.



  • 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
  • This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.


This public work may be used under the terms of the public interest source This public work may be used under the terms of the public interest source
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