PMID- 18086133
OWN - NLM
STAT- MEDLINE
DCOM- 20080507
LR  - 20101118
IS  - 0896-4327 (Print)
IS  - 0896-4327 (Linking)
VI  - 21
IP  - 1
DP  - 2008 Feb
TI  - Management of multivessel coronary disease after ST elevation myocardial 
      infarction treated by primary angioplasty.
PG  - 1-7
AB  - BACKGROUND: Optimal treatment strategy of patients with ST elevation myocardial 
      infarction (STEMI) and multivessel coronary artery disease (CAD) undergoing 
      primary angioplasty is still unclear. Percutaneous coronary intervention (PCI) of 
      non-culprit vessels simultaneously or soon after primary angioplasty is feasible 
      and safe, but available data failed to consistently show a benefit in long-term 
      clinical outcomes. METHODS: We retrospectively compared in-hospital and long-term 
      outcomes for patients with STEMI and multivessel CAD treated by primary 
      angioplasty with (Group 1, n=64) or without (Group 2, n=46) early, staged PCI of 
      other angiographically significant coronary lesions. In-hospital major adverse 
      cardiovascular events (MACE) were defined as a composite of death, periprocedural 
      myocardial infarction after staged, elective PCI, stroke, stent thrombosis, major 
      bleeding, and vascular complications. MACE at follow-up were defined as a 
      composite of death, stroke, stent thrombosis, any coronary revascularization, and 
      re-hospitalization for acute coronary syndrome. RESULTS: Group 1 patients 
      underwent staged PCI 5.9 +/- 3.5 days after primary angioplasty. The mean length 
      of follow-up was 13 months (392 +/- 236 days). The incidence of in-hospital MACE 
      was 20.3% in Group 1 and 10.8% in Group 2 (P=0.186); the incidence of out of 
      hospital MACE was 9.3% in Group 1 and 23.9% in Group 2 (P=0.037). In Group 1 
      in-hospital MACE were driven by periprocedural myocardial infarction after the 
      elective procedure, which occurred in 15.6% of patients. CONCLUSIONS: Our data 
      show that multivessel, staged PCI in STEMI patients is associated with a low 
      incidence of adverse events at follow-up but with a higher incidence of 
      in-hospital MACE, mainly driven by periprocedural myocardial infarction during 
      the elective procedure.
FAU - Rigattieri, Stefano
AU  - Rigattieri S
AD  - Interventional Cardiology Unit, Cardiology Department, "Sandro Pertini" Hospital, 
      Rome, Italy. stefanorigattieri@yahoo.it
FAU - Biondi-Zoccai, Giuseppe
AU  - Biondi-Zoccai G
FAU - Silvestri, Pasquale
AU  - Silvestri P
FAU - Di Russo, Cristian
AU  - Di Russo C
FAU - Musto, Carmine
AU  - Musto C
FAU - Ferraiuolo, Giuseppe
AU  - Ferraiuolo G
FAU - Loschiavo, Paolo
AU  - Loschiavo P
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20071212
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon/*adverse effects
MH  - Angioplasty, Balloon, Coronary/adverse effects
MH  - Coronary Artery Disease/*pathology/physiopathology
MH  - Coronary Vessels/*pathology
MH  - Endpoint Determination
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*complications/physiopathology/therapy
MH  - Retrospective Studies
MH  - *Treatment Outcome
EDAT- 2007/12/19 09:00
MHDA- 2008/05/08 09:00
CRDT- 2007/12/19 09:00
PHST- 2007/12/19 09:00 [pubmed]
PHST- 2008/05/08 09:00 [medline]
PHST- 2007/12/19 09:00 [entrez]
AID - JOIC317 [pii]
AID - 10.1111/j.1540-8183.2007.00317.x [doi]
PST - ppublish
SO  - J Interv Cardiol. 2008 Feb;21(1):1-7. doi: 10.1111/j.1540-8183.2007.00317.x. Epub 
      2007 Dec 12.