Thirty-day outcomes of in-hospital multi-vessel versus culprit-only revascularization strategy for ST-segment elevation myocardial infarction with multivessel coronary disease
Yu-Xi LI1
Bei-Ning WANG1
Fang-Fang FAN1
Yan ZHANG1
Jie JIANG1
Jian-Ping LI1
Ya-Ling HAN2
Yong Huo1
CCC investigators
1.Department of Cardiology,Peking University First Hospital,Beijing,China2.Cardiovascular Research Institute and Department of Cardiology,General Hospital of Northern Theater Command,Shenyang,Liaoning,China
摘要：BACKGROUND Many studies have demonstrated the benefit of complete multivessel revascularization versus culprit-only in-tervention in patients of ST-segment elevation myocardial infarction(STEMI)and multivessel coronary artery disease.However,only a few single-center retrospective studies were performed on small Chinese cohorts.Our study aims to demonstrate the ad-vantage of multivessel percutaneous intervention(PCI)strategy on 30-day in-hospital outcomes to patients with STEMI and mul-tivessel disease in larger Chinese population.METHODS From the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS)project,5935 patients with STEMI and multivessel disease undergoing PCI and hospitalized for fewer than 30 days were analyzed.After 5:1 propensity score matching,3577 patients with culprit-only PCI and 877 with in-hospital multivessel PCI were included.The primary outcome was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of myocardial infarction,all-cause death,stent thrombosis,heart failure,and stroke. RESULTS Multivariable logistic regression analysis revealed that in-hospital multivessel PCI was associated with lower risk of 30-day MACCE(adjusted OR = 0.75,95％CI:0.57-0.98,P = 0.032)than culprit-only PCI and conferred no increased risk of all-cause death,myocardial infarction,stent thrombosis,stroke,or bleeding.Subgroup analysis showed that MACCE reduction was observed more often from patients with trans-femoral access(OR = 0.34,95％CI:0.15-0.74)than with trans-radial access(OR = 0.87,95％CI:0.66-1.16,P for interaction = 0.017).CONCLUSIONS The in-hospital multivessel PCI strategy was associated with a lower risk of 30-day MACCE than culprit-only PCI in patients with STEMI and multivessel coronary artery disease.
机标关键词：st-segmentstrategyrevawithcoronaryculprit-onlydiseaseelevation
论文发表日期：2023-07-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 485-494 )