PMID- 19515083
OWN - NLM
STAT- MEDLINE
DCOM- 20100929
LR  - 20230120
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Linking)
VI  - 22
IP  - 4
DP  - 2009 Aug
TI  - Culprit-only or multivessel percutaneous coronary stenting in patients with 
      non-ST-segment elevation acute coronary syndromes: one-year follow-up.
PG  - 329-35
LID - 10.1111/j.1540-8183.2009.00477.x [doi]
AB  - OBJECTIVE: To investigate the major cardiac events at 1-year follow-up of 
      multivessel versus culprit-vessel stenting in patients presenting with non-ST 
      elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD). 
      INTRODUCTION: Percutaneous coronary intervention is a standard revascularization 
      strategy for patients with NSTE-ACS. However, when these patients have MVD it is 
      not clear whether multivessel (MVR) is superior to culprit-vessel 
      revascularization (CVR). METHODS: We screened 1,100 consecutive patients with 
      NSTE-ACS from an institutional database. Comparisons of 1-year outcomes between 
      multivessel and culprit-vessel revascularized patients were made. The primary 
      outcome was the composite (MACE) of death, myocardial infarction (MI), or any 
      revascularization. Secondary end-points were the components of the composite 
      end-point. Regression analysis was performed to detect predictors of MACE. 
      RESULTS: A total of 609 patients were considered for this analysis: 204 (33.5%) 
      and 405 (66.5%) had MVR and CVR treatment, respectively. The strategy adopted was 
      based on a clinical decision. The incidence of MACE was lower in MVR (9.45% vs. 
      16.34%, P = 0.02) with lower revascularization rate (7.46% vs. 13.86%, P = 0.04) 
      than in CVR. There was no difference in death (1.99% vs. 1.98%, P = 0.8) nor 
      death/MI (2.49% vs. 3.22%, P = 0.8) between MVR and CVR, respectively. 
      Multivariate analysis showed CVR as the only independent predictor of improved 
      MACE (OR 0.66, CI95% 1.12-3.47, P = 0.01). CONCLUSION: Multivessel stenting in 
      patients with NSTE-ACS and multivessel disease using a clinical decision of 
      treatment is associated with lower rate of MACE driven by lower repeat 
      revascularization, compared with culprit-vessel stenting, without difference in 
      rates of death or MI.
FAU - Zapata, Gerardo O
AU  - Zapata GO
AD  - Department of Cardiology, Institute Cardiovascular of Rosario, Rosario, Santa Fe, 
      Argentina.
FAU - Lasave, Leandro I
AU  - Lasave LI
FAU - Kozak, Fernando
AU  - Kozak F
FAU - Damonte, Anibal
AU  - Damonte A
FAU - Meirino, Alejandro
AU  - Meirino A
FAU - Rossi, Maximiliano
AU  - Rossi M
FAU - Carbo, Sabrina
AU  - Carbo S
FAU - Pollice, Analia
AU  - Pollice A
FAU - Paolasso, Ernesto
AU  - Paolasso E
FAU - Picabea, Eduardo
AU  - Picabea E
LA  - eng
PT  - Journal Article
DEP - 20090608
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
SB  - IM
MH  - Acute Coronary Syndrome/mortality/pathology/*therapy
MH  - *Angioplasty, Balloon, Coronary
MH  - Coronary Artery Disease/pathology/therapy
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prospective Studies
MH  - *Stents
MH  - Time Factors
EDAT- 2009/06/12 09:00
MHDA- 2010/09/30 06:00
CRDT- 2009/06/12 09:00
PHST- 2009/06/12 09:00 [entrez]
PHST- 2009/06/12 09:00 [pubmed]
PHST- 2010/09/30 06:00 [medline]
AID - JOIC477 [pii]
AID - 10.1111/j.1540-8183.2009.00477.x [doi]
PST - ppublish
SO  - J Interv Cardiol. 2009 Aug;22(4):329-35. doi: 10.1111/j.1540-8183.2009.00477.x. 
      Epub 2009 Jun 8.