The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Effect of revascularization strategy in patients with acute myocardial infarction and renal insufficiency with multivessel disease

  • Park, Hyukjin (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Hong, Young Joon (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Rhew, Si Hyun (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Kim, Sung Soo (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Jeong, Young Wook (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Jeong, Hae Chang (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Cho, Jae Yeong (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Jang, Soo Young (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Lee, Ki Hong (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Park, Keun Ho (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Sim, Doo Sun (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Yoon, Nam Sik (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Yoon, Hyun Ju (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Kim, Kye Hun (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Park, Hyung Wook (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Kim, Ju Han (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Ahn, Youngkeun (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Jeong, Myung Ho (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Cho, Jeong Gwan (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare) ;
  • Park, Jong Chun (Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital and Convergence Research Center Nominated by Korea Ministry of Health and Welfare)
  • Received : 2013.12.26
  • Accepted : 2014.06.13
  • Published : 2015.03.01
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Abstract

Background/Aims: The aim of this study was to compare the risk of complications and outcome between infarct-related artery (IRA)-only revascularization and multivessel (MV) revascularization in patients with acute myocardial infarction (MI) with renal insufficiency and MV disease. Methods: A total of 1,031 acute MI patients with renal insufficiency and MV disease who were registered in the Korea Working Group on Myocardial Infarction were enrolled. They were divided into two groups (IRA-only revascularization group, n = 404; MV revascularization group, n = 627), and investigated the cumulative incidence of major adverse cardiac events (MACE) and the incidence of complications after percutaneous coronary intervention (PCI). Results: Complications after PCI occurred in 19.9% of all patients (206/1,031). Complications after PCI occurred more frequently in the MV revascularization group compared with the IRA-only revascularization group (20.1% [126/627] vs. 15.3% [62/404], respectively; p = 0.029]. The overall in-hospital mortality rate was 6.3%, and there was no significant difference between the groups (5.2% in the IRA-only revascularization group vs. 7.0% in the MV revascularization group; p = 0.241). The total incidence of MACE was 11.1%, and there was no significant difference between the groups (11.6% in the IRA-only revascularization group vs. 10.7% in the MV revascularization group; p = 0.636). Conclusions: The incidence of complications after PCI was significantly lower in the IRA-only revascularization group compared with the MV revascularization group. However, there were no significant difference in the 12-month outcomes between groups in patients with acute MI and renal insufficiency with MV disease.

Keywords

Acknowledgement

Supported by : Ministry of Health and Welfare

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