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Korean Circ J. 2018 Nov;48(11):989-999. English. Original Article.
Kwon SW , Park SD , Moon J , Oh PC , Jang HJ , Park HW , Kim TH , Lee K , Suh J , Kang W .
Department of Cardiology, Inha University Hospital, Incheon, Korea.
Department of Cardiology, Gachon University Gil Medical Center, Incheon, Korea.
Department of Cardiology, Sejong General Hospital, Bucheon, Korea.
Department of Cardiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

Background and Objectives

We aimed to compare outcomes of complete revascularization (CR) versus culprit-only revascularization for ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) in the 2(nd) generation drug-eluting stent (DES) era.


From 2009 to 2014, patients with STEMI and MVD, who underwent primary percutaneous coronary intervention (PCI) using a 2(nd) generation DES for culprit lesions were enrolled. CR was defined as PCI for a non-infarct-related artery during the index admission. Major adverse cardiovascular event (MACE) was defined as cardiovascular (CV) death, non-fatal myocardial infarction, target lesion revascularization, or heart failure during the follow-up year.


In total, 705 MVD patients were suitable for the analysis, of whom 286 (41%) underwent culprit-only PCI and 419 (59%) underwent CR during the index admission. The incidence of MACE was 11.5% in the CR group versus 18.5% in the culprit-only group (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.37–0.86; p < 0.01; adjusted HR, 0.64; 95% CI, 0.40–0.99; p=0.04). The CR group revealed a significantly lower incidence of CV death (7.2% vs. 12.9%; HR, 0.51; 95% CI, 0.31–0.86; p=0.01 and adjusted HR, 0.57; 95% CI; 0.32–0.97; p=0.03, respectively).


CR was associated with better outcomes including reductions in MACE and CV death at 1 year of follow-up compared with culprit-only PCI in the 2(nd) generation DES era.

Copyright © 2019. Korean Association of Medical Journal Editors.