Clinical investigationMultivessel percutaneous coronary intervention in patients with multivessel disease and acute myocardial infarction
Section snippets
Study patients
Between 1998 and 2002, 820 patients with AMI were treated with primary PCI. Patients were stratified according to the presence or absence of MVD, which was defined as ≥70% stenosis of ≥2 epicardial coronary arteries or their major branches. Patients with MVD were further classified according to the strategy used for revascularization. Patients in the IRA-only group had only the infarct-related vessel treated, whereas patients in the multivessel PCI group had both the infarct-related and
Results
From January 1998 to January 2002, 820 consecutive patients meeting the entry criteria for this study underwent primary coronary angioplasty for AMI at our institution. Of these patients, 314 (38%) had single-vessel disease (SVD) and 506 (62%) had MVD. Of the patients with MVD, 354 underwent PCI restricted to the IRA only, whereas 152 underwent multivessel PCI, either during the same procedure (N = 26) or in a staged fashion during the index hospitalization (N = 126) (Figure 2).
Discussion
MVD occurs in between 40% and 65% of patients with AMI at presentation1, 2, 3 and confers an increased risk of morbidity and mortality after reperfusion therapy.1, 4, 5 In the setting of AMI, percutaneous revascularization of the culprit lesion is efficacious;6, 7, 8 however, treatment of non-culprit lesions in patients with MVD remains controversial. This study demonstrates that in patients with MVD and AMI, multivessel PCI is technically feasible, but is associated with higher post-procedural
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