PMID- 17428557
OWN - NLM
STAT- MEDLINE
DCOM- 20080118
LR  - 20220419
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 123
IP  - 3
DP  - 2008 Jan 24
TI  - Culprit only versus complete coronary revascularization during primary PCI.
PG  - 288-92
AB  - BACKGROUND: Primary percutaneous intervention (PCI) is the treatment of choice 
      for acute ST elevation myocardial infarction. Currently it is recommended to 
      treat only the culprit artery during the acute procedure. Only few reports 
      describe the results of simultaneous non-culprit vessel PCI. The study 
      hypothesizes that complete revascularization during primary PCI can be achieved 
      safely with an improved clinical outcome during the indexed hospitalization. 
      METHODS: One hundred and twenty consecutive patients presented with acute ST 
      elevation myocardial infarction (STEMI) and multivessel coronary stenosis. Ninety 
      five underwent complete revascularization (CR): the culprit artery was opened 
      first followed by dilatation of the other significantly narrowed arteries. Twenty 
      five had culprit only revascularization (COR): the culprit artery only was 
      dilated and the other arteries were left untreated during the primary PCI. 
      RESULTS: Complete revascularization (CR) was associated with reduced incidence of 
      major cardiac events (recurrent ischemia, reinfarction, acute heart failure and 
      in-hospital mortality 16.7 versus 52%, P=0.0001). There was a significant lower 
      rate of recurrent ischemic episodes (4.2% versus 32%, P=0.002), myocardial 
      reinfarction (3.1% versus 16%, P=0.01), reintervention (7.3% versus 32%, 
      P=0.001), acute heart failure (9.4% versus 32%, P=0.01) during the indexed 
      hospitalization and shorter hospitalization (4.4+/-1.27 versus 9.6+/-2.3, 
      P=0.001) in the CR group. Transient renal dysfunction was more common in CR 
      patients (8.4% versus 4% P=0.01). In-hospital and one year mortality were similar 
      between the two groups. CONCLUSION: Multivessel PCI during acute myocardial 
      infarction is feasible and safe. Complete revascularization resulted in an 
      improved acute clinical course. These data support a policy of complete 
      revascularization during primary PCI for STEMI.
FAU - Qarawani, Dahud
AU  - Qarawani D
AD  - Cardiovascular Department, Poria Medical Center, Israel.
FAU - Nahir, Menachem
AU  - Nahir M
FAU - Abboud, Mouin
AU  - Abboud M
FAU - Hazanov, Yevgeny
AU  - Hazanov Y
FAU - Hasin, Yonathan
AU  - Hasin Y
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20070410
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Aged
MH  - Analysis of Variance
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - Cohort Studies
MH  - Confidence Intervals
MH  - Coronary Angiography
MH  - Coronary Stenosis/diagnosis/mortality/*therapy
MH  - Coronary Vessels/*pathology
MH  - Electrocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/mortality/*therapy
MH  - Odds Ratio
MH  - Probability
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2007/04/13 09:00
MHDA- 2008/01/19 09:00
CRDT- 2007/04/13 09:00
PHST- 2006/08/23 00:00 [received]
PHST- 2006/11/24 00:00 [revised]
PHST- 2006/12/11 00:00 [accepted]
PHST- 2007/04/13 09:00 [pubmed]
PHST- 2008/01/19 09:00 [medline]
PHST- 2007/04/13 09:00 [entrez]
AID - S0167-5273(07)00299-9 [pii]
AID - 10.1016/j.ijcard.2006.12.013 [doi]
PST - ppublish
SO  - Int J Cardiol. 2008 Jan 24;123(3):288-92. doi: 10.1016/j.ijcard.2006.12.013. Epub 
      2007 Apr 10.