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Korean Circ J. 2011 Dec;41(12):718-725. English. Original Article. https://doi.org/10.4070/kcj.2011.41.12.718
Jo HS , Park JS , Sohn JW , Yoon JC , Sohn CW , Lee SH , Hong GR , Shin DG , Kim YJ , Jeong MH , Chae SC , Hur SH , Hong TJ , Seong IW , Chae JK , Rhew JY , Chae IH , Cho MC , Bae JH , Rha SW , Kim CJ , Choi DH , Jang YS , Yoon JH , Chung WS , Seung KB , Park SJ .
Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea. pjs@med.yu.ac.kr
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea.
Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Korea.
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
Department of Internal Medicine, Chonbuk National University College of Medicine, Jeonju, Korea.
Department of Internal Medicine, Jeonju Presbyterian Medical Center, Jeonju, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Korea.
Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Yonsei University Severans Hospital, Seoul, Korea.
Department of Internal Medicine, Yonsei University Wonju Christian Hospital, Wonju, Korea.
Department of Internal Medicine, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract

BACKGROUND AND OBJECTIVES: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization (CR) for non-culprit lesions is not routinely recommended. The aim of this study was to compare the clinical outcomes of multivessel compared with infarct-related artery (IRA)-only revascularization in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI. SUBJECTS AND METHODS: From the Korean Acute Myocardial Infarction Registry (KAMIR) database, 1,094 STEMI patients with multivessel disease who underwent primary PCI with drug-eluting stents were enrolled in this study. The patients were divided into two groups: culprit-vessel-only revascularization (COR, n=827) group; multivessel revascularization, including non-IRA (MVR, n=267) group. The primary endpoint of this study included major adverse cardiac events (MACEs), such as death, myocardial infarction, or target or nontarget lesion revascularization at one year. RESULTS: There was no difference in clinical characteristics between the two groups. During the one-year follow-up, 102 (15.2%) patients in the COR group and 32 (14.2%) in the MVR group experienced at least one MACE (p=0.330). There were no differences between the two groups in terms of rates of death, myocardial infarction, or revascularization (2.1% vs. 2.0%, 0.7% vs. 0.8%, and 11.7% vs. 10.1%, respectively; p=0.822, 0.910, and 0.301, respectively). The MACE rate was higher in the incompletely revascularized patients than in the completely revascularized patients (15% vs. 9.5%, p=0.039), and the difference was attributable to a higher rate of nontarget vessel revascularization (8.6% vs. 1.8%, p=0.002). CONCLUSION: Although multivessel angioplasty during primary PCI for STEMI did not reduce the MACE rate compared with culprit-vessel-only PCI, CR was associated with a lower rate of repeat revascularization after multivessel PCI.

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