Outcome of urgent percutaneous transluminal coronary angioplasty in acute myocardial infarction: Comparison of single-vessel versus multivessel coronary artery disease

Jaski, Brian E.; Cohen, Joshua D.; Trausch, Josefina; Marsh, David G.; Bail, Gregory R.; Overlie, Paul; E, Skowroński; Smith, Sidney C.

doi:10.1016/0002-8703(92)90053-x

Cited by 132 publications

(65 citation statements)

References 27 publications

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“…MVD has been previously demonstrated to be an unfavorable prognostic factor compared with SVD in patients with AMI. 7,8,23,24) In concert with this finding, our results showed that the 30-day and 1-year cumula- …”

Section: Discussionsupporting

confidence: 82%

“…Rationale of elective PCI for non-IRA in STEMI patients after primary PCI: Interestingly, while the prognostic outcome is worse in patients with MVD than in those with SVD in the setting of STEMI 7,8,23,24) and complete revascularization by means of coronary artery bypass graft surgery in MVD patients is known to offer additional benefits in improving clinical outcomes, 11,12,30) the benefits of PCI for non-IRA on clinical outcome in STEMI patients undergoing primary PCI are still inconsistent. 16,17,20,21) Some studies have suggested that complete revascularization during primary PCI has a positive impact on the clinical outcome.…”

Section: Figurementioning

confidence: 99%

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Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

et al. 2010

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SummaryThis study compared the prognosis of ST-elevation myocardial infarction (STEMI) in patients with multivessel disease (MVD) with that of single vessel disease (SVD) and investigated the revascularization benefit of noninfarct-related artery (IRA) in MVD patients undergoing primary percutaneous coronary intervention (PCI). Between 2002 and 2009, 1278 patients with STEMI underwent primary PCI. Of these patients, 717 (56.1%) with SVD (only IRA obstruction) were placed in group A, while 561 (43.9%) with MVD (Group B) were further categorized into group 1 (PCI for IRA) and group 2 (staged PCI for IRA+non-IRA). The results demonstrated a lower degree of successful reperfusion in IRA and higher 30-day and 1-year cumulative mortality rates in group B (P < 0.001). While there was no difference in successful reperfusion in IRA between group 1 and group 2, the 30-day and one-year cumulative mortality rates were higher in group 1. Multivariate analysis identified MVD as an independent predictor of 1-year mortality (P < 0.001). In conclusion, patients with subsequent PCI for MVD had better 30-day and 1-year outcomes than those with conservative treatment. (Int Heart J 2010; 51: 319-324)

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Section: Discussionsupporting

confidence: 82%

Section: Figurementioning

confidence: 99%

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

et al. 2010

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“…Patients who developed MACCE were older and showed a higher prevalence of coronary multivessel disease, highlighting the prognostic role of these conditions 25. Moreover, patients with MACCE showed significantly higher NT‐proBNP concentrations and lower LV stroke volume, confirming the prognostic role of natriuretic peptides and LV dysfunction after acute STEMI 1, 26.…”

Section: Discussionmentioning

confidence: 80%

Prognostic Value of Aortic Stiffness in Patients After ST‐Elevation Myocardial Infarction

Feistritzer

Klug

Reinstadler

et al. 2017

JAHA

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BackgroundHigh aortic stiffness has been shown to be a strong predictor of morbidity and mortality in the general population and several patient cohorts. However, in patients after ST‐elevation myocardial infarction, the prognostic value of high aortic stiffness is unknown so far.Methods and ResultsThis prospective observational study included 160 consecutive patients with first acute ST‐elevation myocardial infarction. Aortic pulse wave velocity (PWV) was measured 2 (interquartile range 2‐4 days) days after infarction using cardiac magnetic resonance imaging. The primary end point was defined as a composite end point of major adverse cardiac and cerebrovascular events (MACCE) comprising death, nonfatal myocardial reinfarction, new congestive heart failure, and stroke. During a median follow‐up of 1.2 years (interquartile range 1.0‐3.1 years), 19 (12%) MACCE events occurred. Kaplan‐Meier analysis showed a significantly lower MACCE‐free survival in patients with high PWV (PWV >7.3 m/s, log‐rank P=0.003). Multivariable Cox regression analysis revealed PWV >7.3 m/s to be an independent predictor of MACCE after adjustment for age, sex, mean blood pressure, N‐terminal pro–brain natriuretic peptide levels, presence of multivessel disease, and left ventricular stroke volume (hazard ratios ≥3.5; 95% confidence interval 1.4‐13.3; all P≤0.018). In reclassification analysis the addition of PWV to a risk model comprising major clinical prognostic parameters led to a net reclassification improvement of 0.11 (95% confidence interval 0.06‐0.17; P<0.001).ConclusionsIncreased aortic stiffness is an independent predictor of MACCE after acute ST‐elevation myocardial infarction. Moreover, the assessment of aortic stiffness in addition to classical risk factors significantly improved early risk stratification.

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“…4,5 In the Framingham and Fast Revascularization During Instability in Coronary Artery Disease (FRISC) II trial, one of the landmark studies that changed the NSTEMI strategy toward an early invasive strategy, revascularization was recommended in any artery with ≥70% stenosis. 6 However, it is not clear whether multivessel percutaneous coronary intervention (PCI) beyond the culprit lesion in patients with NSTE-ACS and MVD can improve long-term prognosis.…”

Section: Introductionmentioning

confidence: 99%

Multivessel vs Single‐Vessel Revascularization in Patients With Non–ST‐Segment Elevation Acute Coronary Syndrome and Multivessel Disease in the Drug‐Eluting Stent Era

Lee

Song

Hahn

et al. 2011

Clinical Cardiology

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Background: We sought to compare long-term outcomes for multivessel revascularization (MVR) vs singlevessel revascularization (SVR) with drug-eluting stents (DES) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and multivessel coronary artery disease (MVD). Hypothesis: In DES era, MVR would improve long-term clinical outcomes in patients with NSTE-ACS. Methods: We studied 179 patients undergoing MVR and 187 patients undergoing SVR for NSTE-ACS and MVD. Major adverse cardiac events (MACE) were defined as death, myocardial infarction, or any revascularization. ) and myocardial infarction (HR: 0.39, 95% CI: 0.11-1.47). The incidence of periprocedural renal dysfunction was not significantly different between patients undergoing MVR vs SVR (3.4% vs 1.6%, P = 0.33). Definite or probable stent thrombosis occurred at a similar rate (2.2% in the MVR group and 2.7% in the SVR group, P = 0.99). Conclusions:In patients with NSTE-ACS and MVD, MVR using drug-eluting stents may reduce MACE. Our findings should be confirmed by a prospective, randomized trial.

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Outcome of urgent percutaneous transluminal coronary angioplasty in acute myocardial infarction: Comparison of single-vessel versus multivessel coronary artery disease

Cited by 132 publications

References 27 publications

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Benefit of Revascularization in Non-Infarct-Related Artery in Multivessel Disease Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Prognostic Value of Aortic Stiffness in Patients After ST‐Elevation Myocardial Infarction

Multivessel vs Single‐Vessel Revascularization in Patients With Non–ST‐Segment Elevation Acute Coronary Syndrome and Multivessel Disease in the Drug‐Eluting Stent Era

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