Abstract 17179: The Optimal Time of Percutaneous Coronary Intervention for Non-Culprit Vessel in Acute Myocardial Infarction Patients With Multivessel Disease
Objectives: To determine the optimal time of percutaneous coronary intervention (PCI) for non-culprit vessel in acute myocardial infarction (AMI) patients with multivessel disease (MVD).
Background: HORIZONS-AMI trial reported that staged PCI was related with better prognosis than single PCI. However, the optimal time of the second-stage PCI for non-culprit vessel is not clear.
Methods: A total of 2,630 patients with AMI with MVD from 9 centers of 2 universities were registered in prospective COREA-AMI registry (COnvergent REgistry of catholic and chonnAm university for Acute MI) from Jan 2004 through Dec 2009. Out of these, we selected 1,397 patients treated by multivessel PCI. The eligible patients were divided by 5 groups according to the time interval from primary PCI to second stage PCI: group I (0 day, single PCI for culprit and non-culprit artery), group II (1-3 days after), group III (4-7 days after), group IV (8-14 days after), and group V (more than 15 days after). The endpoint was incidence of major adverse cardiac events (MACE) including cardiac death, re-MI, re-PCI during 1 year.
Results: Study population was consisted with 753 patients with ST-segment elevation MI (STEMI) and 644 patients with non-STEMI. 982 patients were male, and their mean age was 64.2 years old. The composite of MACEs were significantly lowest in group III (p<0.001), and the major determinant of difference was the cardiac death (Table 1). These results were consistent in both subgroups, STEMI and non-STEMI.
Conclusions: Performing the second stage PCI for non culprit vessel 4-7 days after primary PCI associated with lowest incidences of MACEs in AMI patient with MVD.
- © 2013 by American Heart Association, Inc.