Published in:
Open Access 01-12-2016 | Research article
Culprit-only versus staged complete revascularization for patients with ST-segment elevation myocardial infarction and Multivessel disease: a retrospective cohort study
Published in: BMC Cardiovascular Disorders | Issue 1/2016
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Background
Multivessel disease (MVD) is common in patients with ST-segment elevation myocardial infarction (STEMI), but optimal treatment management remains undetermined.
Methods
In this retrospective cohort study, 602 consecutive STEMI patients with MVD were enrolled between January 1, 2010 and October 1, 2014. Three hundred and eighty-two patients underwent culprit-only revascularization and 220 underwent staged complete revascularization. Primary end points were a composite of cardiac mortality or nonfatal reinfarction.
Results
The mean duration of follow-up was 35 months (12–71 months). Following multivariate analysis, staged complete revascularization was associated with a lower rate of the composite of cardiac mortality or nonfatal reinfarction [HR: 0.430, 95 % CI: 0.197–0.940, P = 0.034] and unplanned repeat revascularization [HR: 0.343, 95 % CI: 0.166–0.708, P = 0.004] compared with culprit-only revascularization.
Conclusions
Compared with culprit-only revascularization, staged complete revascularization significantly reduced the rate of the composite of cardiac mortality or nonfatal reinfarction, and the need for unplanned repeat revascularization.