Culprit-lesion-only versus multivessel revascularization using drug-eluting stents in patients with ST-segment elevation myocardial infarction: A Korean Acute Myocardial Infarction Registry-based analysis

Hyun Su Jo, Jong Seon Park, Jang Won Sohn, Joon Cheol Yoon, Chang Woo Sohn, Sang Hee Lee, Geu Ru Hong, Dong Gu Shin, Young Jo Kim, Myung Ho Jeong, Shung Chull Chae, Seung Ho Hur, Taek Jong Hong, In Whan Seong, Jei Keon Chae, Jay Young Rhew, In Ho Chae, Myeong Chan Cho, Jang Ho Bae, Seung Woon RhaChong Jin Kim, Dong Hoon Choi, Yang Soo Jang, Jung Han Yoon, Wook Sung Chung, Ki Bae Seung, Seung Jung Park

Research output: Contribution to journalArticle

29 Citations (Scopus)

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-vesselonly 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.

Original languageEnglish
Pages (from-to)718-725
Number of pages8
JournalKorean Circulation Journal
Volume41
Issue number12
DOIs
Publication statusPublished - 2011 Dec 1

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Drug-Eluting Stents
Registries
Percutaneous Coronary Intervention
Myocardial Infarction
Arteries
Myocardial Revascularization
ST Elevation Myocardial Infarction
Angioplasty
Databases
Mortality

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Jo, Hyun Su ; Park, Jong Seon ; Sohn, Jang Won ; Yoon, Joon Cheol ; Sohn, Chang Woo ; Lee, Sang Hee ; Hong, Geu Ru ; Shin, Dong Gu ; Kim, Young Jo ; Jeong, Myung Ho ; Chae, Shung Chull ; Hur, Seung Ho ; Hong, Taek Jong ; Seong, In Whan ; Chae, Jei Keon ; Rhew, Jay Young ; Chae, In Ho ; Cho, Myeong Chan ; Bae, Jang Ho ; Rha, Seung Woon ; Kim, Chong Jin ; Choi, Dong Hoon ; Jang, Yang Soo ; Yoon, Jung Han ; Chung, Wook Sung ; Seung, Ki Bae ; Park, Seung Jung. / Culprit-lesion-only versus multivessel revascularization using drug-eluting stents in patients with ST-segment elevation myocardial infarction : A Korean Acute Myocardial Infarction Registry-based analysis. In: Korean Circulation Journal. 2011 ; Vol. 41, No. 12. pp. 718-725.
@article{eba0255f6c3a45f6a2603a29fa5f9a59,
title = "Culprit-lesion-only versus multivessel revascularization using drug-eluting stents in patients with ST-segment elevation myocardial infarction: A Korean Acute Myocardial Infarction Registry-based analysis",
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-vesselonly 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.",
author = "Jo, {Hyun Su} and Park, {Jong Seon} and Sohn, {Jang Won} and Yoon, {Joon Cheol} and Sohn, {Chang Woo} and Lee, {Sang Hee} and Hong, {Geu Ru} and Shin, {Dong Gu} and Kim, {Young Jo} and Jeong, {Myung Ho} and Chae, {Shung Chull} and Hur, {Seung Ho} and Hong, {Taek Jong} and Seong, {In Whan} and Chae, {Jei Keon} and Rhew, {Jay Young} and Chae, {In Ho} and Cho, {Myeong Chan} and Bae, {Jang Ho} and Rha, {Seung Woon} and Kim, {Chong Jin} and Choi, {Dong Hoon} and Jang, {Yang Soo} and Yoon, {Jung Han} and Chung, {Wook Sung} and Seung, {Ki Bae} and Park, {Seung Jung}",
year = "2011",
month = "12",
day = "1",
doi = "10.4070/kcj.2011.41.12.718",
language = "English",
volume = "41",
pages = "718--725",
journal = "Korean Circulation Journal",
issn = "1738-5520",
publisher = "Korean Society of Circulation",
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}

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 2011, 'Culprit-lesion-only versus multivessel revascularization using drug-eluting stents in patients with ST-segment elevation myocardial infarction: A Korean Acute Myocardial Infarction Registry-based analysis', Korean Circulation Journal, vol. 41, no. 12, pp. 718-725. https://doi.org/10.4070/kcj.2011.41.12.718

Culprit-lesion-only versus multivessel revascularization using drug-eluting stents in patients with ST-segment elevation myocardial infarction : A Korean Acute Myocardial Infarction Registry-based analysis. / Jo, Hyun Su; Park, Jong Seon; Sohn, Jang Won; Yoon, Joon Cheol; Sohn, Chang Woo; Lee, Sang Hee; Hong, Geu Ru; Shin, Dong Gu; Kim, Young Jo; Jeong, Myung Ho; Chae, Shung Chull; Hur, Seung Ho; Hong, Taek Jong; Seong, In Whan; Chae, Jei Keon; Rhew, Jay Young; Chae, In Ho; Cho, Myeong Chan; Bae, Jang Ho; Rha, Seung Woon; Kim, Chong Jin; Choi, Dong Hoon; Jang, Yang Soo; Yoon, Jung Han; Chung, Wook Sung; Seung, Ki Bae; Park, Seung Jung.

In: Korean Circulation Journal, Vol. 41, No. 12, 01.12.2011, p. 718-725.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Culprit-lesion-only versus multivessel revascularization using drug-eluting stents in patients with ST-segment elevation myocardial infarction

T2 - A Korean Acute Myocardial Infarction Registry-based analysis

AU - Jo, Hyun Su

AU - Park, Jong Seon

AU - Sohn, Jang Won

AU - Yoon, Joon Cheol

AU - Sohn, Chang Woo

AU - Lee, Sang Hee

AU - Hong, Geu Ru

AU - Shin, Dong Gu

AU - Kim, Young Jo

AU - Jeong, Myung Ho

AU - Chae, Shung Chull

AU - Hur, Seung Ho

AU - Hong, Taek Jong

AU - Seong, In Whan

AU - Chae, Jei Keon

AU - Rhew, Jay Young

AU - Chae, In Ho

AU - Cho, Myeong Chan

AU - Bae, Jang Ho

AU - Rha, Seung Woon

AU - Kim, Chong Jin

AU - Choi, Dong Hoon

AU - Jang, Yang Soo

AU - Yoon, Jung Han

AU - Chung, Wook Sung

AU - Seung, Ki Bae

AU - Park, Seung Jung

PY - 2011/12/1

Y1 - 2011/12/1

N2 - 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-vesselonly 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.

AB - 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-vesselonly 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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