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Rev Port Cardiol. 2014 Feb;33(2):67-73. doi: 10.1016/j.repc.2013.07.015. Epub 2014 Feb 4.

Multivessel approach in ST-elevation myocardial infarction: impact on in-hospital morbidity and mortality.

[Article in English, Portuguese]

Author information

1
Serviço de Cardiologia, Hospital do Espírito Santo, Évora, Portugal. Electronic address: anarita_asantos@hotmail.com.
2
Serviço de Cardiologia, Hospital do Espírito Santo, Évora, Portugal.

Abstract

INTRODUCTION:

Multivessel disease in ST-elevation myocardial infarction (STEMI) is associated with a worse prognosis. A multivessel approach at the time of primary percutaneous coronary intervention (PCI) is the subject of debate.

OBJECTIVE:

To assess the impact of a multivessel approach on in-hospital morbidity and mortality in patients with STEMI undergoing primary PCI.

METHODS:

We studied patients from the Portuguese Registry of Acute Coronary Syndromes with STEMI and multivessel disease who underwent primary PCI. The 257 patients were divided into two groups: those who underwent PCI of the culprit artery only and those who underwent multivessel PCI. Cardiovascular risk factors, STEMI location, in-hospital treatment, number and type of diseased and treated arteries, type of stent implanted and ejection fraction were recorded. The primary end-point was defined as in-hospital mortality and the secondary end-point as the presence of at least one of the following complications: major bleeding, need for transfusion, invasive ventilation, heart failure and reinfarction.

RESULTS:

Multivessel disease was found in 43.3% of the study population and a multivessel approach was adopted in 19.2% of these patients. There were no differences between the groups in cardiovascular risk factors or electrocardiographic presentation of STEMI. Patients undergoing multivessel PCI were more likely to be treated with drug-eluting stents and glycoprotein IIb/IIIa inhibitors, and less likely to receive heparin therapy. There were no differences between the groups with regard to in-hospital mortality or the incidence of complications.

CONCLUSION:

In our population of patients with STEMI, a multivessel approach appears to be safe and not associated with increased in-hospital mortality or morbidity.

KEYWORDS:

Acute myocardial infarction; Angioplastia primária; Doença multivaso; Enfarte agudo do miocárdio; Multivessel disease; Primary percutaneous coronary intervention; Prognosis; Prognóstico

PMID:
24502933
DOI:
10.1016/j.repc.2013.07.015
[Indexed for MEDLINE]
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