Premium
Outcome of staged percutaneous coronary intervention within two weeks from admission in patients with ST‐segment elevation myocardial infarction with multivessel disease
Author(s) -
Fukutomi Motoki,
Toriumi Shinichi,
Ogoyama Yukako,
Oba Yusuke,
Takahashi Masao,
Funayama Hiroshi,
Kario Kazuomi
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27896
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , mace , myocardial infarction , cardiology , culprit , hazard ratio , unstable angina , revascularization , proportional hazards model , angina , confidence interval , surgery
Abstract Background The optimum timing of revascularization strategy for stenoses in nonculprit vessels in patients with ST‐segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) remains unclear. At present, there is no evidence investigating the outcome of staged percutaneous coronary intervention (PCI) within two weeks from admission among STEMI patients with MVD. Methods A total of 210 STEMI patients with MVD who underwent primary PCI were analyzed. We compared the all‐cause mortality and major adverse cardiovascular events (MACE) (cardiovascular death, myocardial infarction, heart failure, unstable angina, and stroke) with median follow‐up of 1200 days among the patients who underwent staged PCI within two weeks from admission (staged PCI ≤2 W) ( n = 75), staged PCI after two weeks from admission (staged PCI >2 W) ( n = 37) and culprit‐only PCI ( n = 98) in patients with STEMI and MVD. Results The staged PCI ≤2 W showed lower all‐cause mortality than culprit‐only PCI (4.0 vs 29.6%, log‐rank P = 0.001), and lower incidence of MACE than the staged PCI >2 W group (1.3 vs 18.9%, log‐rank P = 0.001) and culprit‐only PCI group (1.3 vs 22.5%, log‐rank P = 0.001). In the multivariable Cox regression analysis, the staged PCI ≤2 W was a predictor of lower all‐cause mortality (hazard ratio [HR], 0.176; 95% confidence interval [CI], 0.049‐0.630; P = 0.008) and lower incidence of MACE (HR, 0.068; 95% CI, 0.009‐0.533; P = 0.011), but staged PCI >2 W was not. Conclusion In conclusion, staged PCI within two weeks after admission showed more favorable outcomes compared with staged PCI after two weeks from admission or culprit‐only PCI in STEMI patients with MVD.