J Yeungnam Med Sci.  2025;42(1):18. 10.12701/jyms.2025.42.18.

Complete or incomplete revascularization in patients with left main culprit lesion acute myocardial infarction with multivessel disease: a retrospective observational study

• Kim SO
• Kim HJ
• Park JI
• Choi KU
• Nam JH
• Lee CH
• Son JW
• Park JS
• Her SH
• Chang KY
• Ahn TH
• Jeong MH
• Rha SW
• Kim HS
• Gwon HC
• Seong IW
• Hwang KK
• Hur SH
• Cha KS
• Oh SK
• Chae JK
• Kim U

• KMID: 2564085
• DOI: http://doi.org/10.12701/jyms.2025.42.18

Abstract

Background
Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.
Methods
We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year.
Results
After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different.
Conclusion
There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Keyword

Acute myocardial infarction; Complete revascularization; Left main; Multivessel disease