Korean Circulation Journal

  • 제41권12호
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  • Pages.718-725
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  • 2011
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Culprit-Lesion-Only Versus Multivessel Revascularization Using Drug-Eluting Stents in Patients With ST-Segment Elevation Myocardial Infarction: A Korean Acute Myocardial Infarction Registry-Based Analysis

  • Jo, Hyun-Su (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Park, Jong-Seon (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Sohn, Jang-Won (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Yoon, Joon-Cheol (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Sohn, Chang-Woo (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Lee, Sang-Hee (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Hong, Geu-Ru (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Shin, Dong-Gu (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Kim, Young-Jo (Division of Cardiology, Department of Internal Medicine, Yeungnam University Hospital) ;
  • Jeong, Myung-Ho (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Chae, Shung-Chull (Department of Internal Medicine, Kyungpook National University College of Medicine) ;
  • Hur, Seung-Ho (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Hong, Taek-Jong (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Seong, In-Whan (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Chae, Jei-Keon (Department of Internal Medicine, Chonbuk National University College of Medicine) ;
  • Rhew, Jay-Young (Department of Internal Medicine, Jeonju Presbyterian Medical Center) ;
  • Chae, In-Ho (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Cho, Myeong-Chan (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Bae, Jang-Ho (Department of Internal Medicine, Konyang University College of Medicine) ;
  • Rha, Seung-Woon (Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Chong-Jin (Department of Internal Medicine, Kyunghee University College of Medicine) ;
  • Choi, Dong-Hoon (Department of Internal Medicine, Yonsei University Severans Hospital) ;
  • Jang, Yang-Soo (Department of Internal Medicine, Yonsei University Severans Hospital) ;
  • Yoon, Jung-Han (Department of Internal Medicine, Yonsei University Wonju Christian Hospital) ;
  • Chung, Wook-Sung (Department of Internal Medicine, The Catholic University of Korea Seoul St. Mary’s Hospital) ;
  • Seung, Ki-Bae (Department of Internal Medicine, The Catholic University of Korea Seoul St. Mary’s Hospital) ;
  • Park, Seung-Jung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2011.12.30
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization (CR) for non-culprit lesions is not routinely recommended. The aim of this study was to compare the clinical outcomes of multivessel compared with infarct-related artery (IRA)-only revascularization in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI. Subjects and Methods: From the Korean Acute Myocardial Infarction Registry (KAMIR) database, 1,094 STEMI patients with multivessel disease who underwent primary PCI with drug-eluting stents were enrolled in this study. The patients were divided into two groups: culprit-vessel-only revascularization (COR, n=827) group; multivessel revascularization, including non-IRA (MVR, n=267) group. The primary endpoint of this study included major adverse cardiac events (MACEs), such as death, myocardial infarction, or target or nontarget lesion revascularization at one year. Results: There was no difference in clinical characteristics between the two groups. During the one-year follow-up, 102 (15.2%) patients in the COR group and 32 (14.2%) in the MVR group experienced at least one MACE (p=0.330). There were no differences between the two groups in terms of rates of death, myocardial infarction, or revascularization (2.1% vs. 2.0%, 0.7% vs. 0.8%, and 11.7% vs. 10.1%, respectively; p=0.822, 0.910, and 0.301, respectively). The MACE rate was higher in the incompletely revascularized patients than in the completely revascularized patients (15% vs. 9.5%, p=0.039), and the difference was attributable to a higher rate of nontarget vessel revascularization (8.6% vs. 1.8%, p=0.002). Conclusion: Although multivessel angioplasty during primary PCI for STEMI did not reduce the MACE rate compared with culprit-vessel-only PCI, CR was associated with a lower rate of repeat revascularization after multivessel PCI.

키워드

참고문헌

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