Abstract 15151: Impact of Multivessel Revascularization on In-Hospital Mortality in Patients with Cardiogenic Shock Complicating ST-Segment Elevation Acute Myocardial Infarction and Multivessel Disease
Background: In acute ST elevation myocardial infarction (STEMI) without cardiogenic shock (CS) undergoing primary percutaneous coronary intervention (PCI), the current guidelines do not recommend intervention on nonculprit vessels. However, no data are available in CS patients with STEMI and multivessel disease. We investigated whether multivessel revascularization is associated with improved survival in hospital.
Methods: A total of 509 patients with CS complicating STEMI treated with primary PCI, 240 patients with multivessel disease were selected from a nationwide, prospective Korea Working Group on Myocardial Infarction (KorMI) registry from January 2008 to September 2010. Primary end point was in-hospital death.
Results: In-hospital mortality was 27.1% for CS. Non-culprit coronary interventions were performed at the time of primary PCI in 51 (21.3%) patients. Independent predictors of in-hospital mortality included age ≥ 75 years (P = 0.046, odd ratio (OR) = 2.37, 95% confidence interval (CI): 1.02-5.52), sinus rhythm on admission (P = 0.008, OR = 0.35, 95% CI: 0.16-0.76), left ventricular ejection fraction < 40% (P = 0.001, OR = 3.98, 95% CI: 1.80-8.78), and glucose serum level > 200mg/dl (P = 0.041, OR = 2.18, 95% CI: 1.03-4.62). However, multivessel revascularization is not independent predictor of in-hospital mortality (P = 0.383, OR=1.46, 95% CI: 0.62-3.43)
Conclusions: Multivessel revascularization was not associated with improved survival in CS patients with STEMI and multivessel disease undergoing primary PCI.
- © 2011 by American Heart Association, Inc.