Abstract 19782: Is Multivessel Revascularization in Patients with ST-Segment Myocardial Infarction Associated with Increased Risk of Acute Complications? Insights from the NHLBI PCI Dynamic Registry
Background: In patients presenting with ST-segment elevation myocardial infarction (STEMI), culprit-only revascularization (COR) strategy is advocated by the guidelines. Intervention on non-culprit lesions is a class III indication (contra-indicated), likely due to concerns about increased risk of complications with a second procedure. However, the data on acute safety of multivessel revascularization is less well defined.
Methods: Patients with multivessel coronary artery disease (MVD) and presenting with STEMI and enrolled in the NHLBI PCI dynamic registry were evaluated. The cohort was divided into 2 groups based on the revascularization strategy at index hospitalization- culprit only versus multivessel revascularization. Acute in-hospital complications an d30-day outcomes were evaluated.
Results: Among the 617 patients with STEMI and MVD, 91 (15%) underwent multivessel revascularization. The baseline characteristics were similar between the multivessel revascularization and the COR groups. Multivesel revascularization was not associated with any increase in the risk of either procedural complications, in-hospital cardiovascular events or 30-day outcomes (Table).
Conclusions: In a select group of patients with STEMI and MVD, multivessel revascularization (during the same hospitalization) appears to be safe. Further large scale randomized trials are needed to test the efficacy of such a strategy.
- © 2010 by American Heart Association, Inc.