Coronary artery diseasePrevalence, Predictors, and In-Hospital Outcomes of Non-Infarct Artery Intervention During Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction (from the National Cardiovascular Data Registry)
Section snippets
Methods
The NCDR, which is co-sponsored by the American College of Cardiology and the Society for Cardiac Angiography and Interventions, has been previously described.7, 8 The NCDR catalogs the clinical data and outcomes of PCI procedures gathered from >600 sites across the United States. The data are entered into NCDR-certified databases at participating institutions and exported in a standard format to a common database at Heart House (Washington, DC). Only institutions whose submissions have met the
Results
A total of 708,481 admissions from 638 sites were entered into the NCDR from 2004 to 2007. We identified 31,681 patients undergoing primary PCI for STEMI who had multivessel coronary artery disease. Of these patients, 8.7% (n = 2,745) underwent staged PCI and were excluded from the analysis, leaving 28,936 patient encounters included in the analysis. Of these, 10.8% (n = 3,134) were treated with multivessel PCI.
Patients who underwent multivessel PCI had a lower incidence of previously
Discussion
Our analysis of a large contemporary PCI database has shown that multivessel coronary interventions during primary PCI for STEMI occurs in ≤10% of PCI cases in clinical practice; however, its use varied considerably among centers. Although no consistency was found in its use, we did find that multivessel PCI in the setting of primary PCI was associated with worse outcomes. Among patients with STEMI without hemodynamic compromise, multivessel PCI did not improve in-hospital outcomes, supporting
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This analysis was supported by a grant from the American College of Cardiology, Washington, DC, and the Society for Cardiac Angiography and Interventions, Washington, DC.
This analysis was supported by the National Cardiovascular Data Registry.
Dr. Roe was supported by research grants from Schering Plough, BMS/Sanofi-Aventis, KAI Pharmaceuticals, and DeCODE Genetics; is on the consulting/advisory boards for Schering Plough, KAI Pharmaceuticals; and is on the Speakers Bureau or has received honoraria from Schering Plough and BMS/Sanofi-Aventis.
Dr. Peterson has received research grants from Bristol-Myers Squibb, Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership, Bristol-Myers Squibb/Merck, and Schering (additional disclosure information for Dr. Peterson is available from: http://dcri.org/research/coi.jsp).
Dr. Rao is a Consultant for Sanofi-Aventis and member of the Speakers' Bureaus for Sanofi-Aventis, Bristol Myers Squibb, and the Medicines Company and has received research funding from Momenta Pharmaceuticals, Portola Pharmaceuticals, and Cordis.