Korean Circulation Journal

  • 제48권11호
  • /
  • Pages.989-999
  • /
  • 2018
  • /
  • 1738-5520(pISSN)
  • /
  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
권호 표지
DOI QR코드

DOI QR Code

Complete Versus Culprit-Only Revascularization for ST-Segment Elevation Myocardial Infarction and Multivessel Disease in the 2nd Generation Drug-Eluting Stent Era: Data from the INTERSTELLAR Registry

  • Kwon, Sung Woo (Department of Cardiology, Inha University Hospital) ;
  • Park, Sang-Don (Department of Cardiology, Inha University Hospital) ;
  • Moon, Jeonggeun (Department of Cardiology, Gachon University Gil Medical Center) ;
  • Oh, Pyung Chun (Department of Cardiology, Gachon University Gil Medical Center) ;
  • Jang, Ho-Jun (Department of Cardiology, Sejong General Hospital) ;
  • Park, Hyun Woo (Department of Cardiology, Soonchunhyang University Bucheon Hospital) ;
  • Kim, Tae-Hoon (Department of Cardiology, Sejong General Hospital) ;
  • Lee, Kyounghoon (Department of Cardiology, Gachon University Gil Medical Center) ;
  • Suh, Jon (Department of Cardiology, Soonchunhyang University Bucheon Hospital) ;
  • Kang, WoongChol (Department of Cardiology, Gachon University Gil Medical Center)
  • 투고 : 2017.12.22
  • 심사 : 2018.05.08
  • 발행 : 2018.11.30
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: We aimed to compare outcomes of complete revascularization (CR) versus culprit-only revascularization for ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) in the $2^{nd}$ generation drug-eluting stent (DES) era. Methods: From 2009 to 2014, patients with STEMI and MVD, who underwent primary percutaneous coronary intervention (PCI) using a $2^{nd}$ generation DES for culprit lesions were enrolled. CR was defined as PCI for a non-infarct-related artery during the index admission. Major adverse cardiovascular event (MACE) was defined as cardiovascular (CV) death, non-fatal myocardial infarction, target lesion revascularization, or heart failure during the follow-up year. Results: In total, 705 MVD patients were suitable for the analysis, of whom 286 (41%) underwent culprit-only PCI and 419 (59%) underwent CR during the index admission. The incidence of MACE was 11.5% in the CR group versus 18.5% in the culprit-only group (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.37-0.86; p<0.01; adjusted HR, 0.64; 95% CI, 0.40-0.99; p=0.04). The CR group revealed a significantly lower incidence of CV death (7.2% vs. 12.9%; HR, 0.51; 95% CI, 0.31-0.86; p=0.01 and adjusted HR, 0.57; 95% CI; 0.32-0.97; p=0.03, respectively). Conclusions: CR was associated with better outcomes including reductions in MACE and CV death at 1 year of follow-up compared with culprit-only PCI in the $2^{nd}$ generation DES era.

키워드

과제정보

연구 과제 주관 기관 : Inha University

참고문헌

  1. Wald DS, Morris JK, Wald NJ, et al. Randomized trial of preventive angioplasty in myocardial infarction. N Engl J Med 2013;369:1115-23. https://doi.org/10.1056/NEJMoa1305520
  2. Gershlick AH, Khan JN, Kelly DJ, et al. Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial. J Am Coll Cardiol 2015;65:963-72. https://doi.org/10.1016/j.jacc.2014.12.038
  3. Engstrom T, Kelbaek H, Helqvist S, et al. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3-PRIMULTI): an open-label, randomised controlled trial. Lancet 2015;386:665-71. https://doi.org/10.1016/S0140-6736(15)60648-1
  4. Levine GN, Bates ER, Blankenship JC, et al. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. J Am Coll Cardiol 2016;67:1235-50.
  5. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012;33:2569-619. https://doi.org/10.1093/eurheartj/ehs215
  6. Dahal K, Rijal J, Panta R, Lee J, Azrin M, Lootens R. Multi-vessel versus culprit-vessel and staged percutaneous coronary intervention in STEMI patients with multivessel disease: a meta-analysis of randomized controlled trials. Cardiovasc Revasc Med 2014;15:408-13. https://doi.org/10.1016/j.carrev.2014.10.007
  7. El-Hayek GE, Gershlick AH, Hong MK, et al. Meta-analysis of randomized controlled trials comparing multivessel versus culprit-only revascularization for patients with ST-segment elevation myocardial infarction and multivessel disease undergoing primary percutaneous coronary intervention. Am J Cardiol 2015;115:1481-6. https://doi.org/10.1016/j.amjcard.2015.02.046
  8. Villablanca PA, Briceno DF, Massera D, et al. Culprit-lesion only versus complete multivessel percutaneous intervention in ST-elevation myocardial infarction: A systematic review and meta-analysis of randomized trials. Int J Cardiol 2016;220:251-9. https://doi.org/10.1016/j.ijcard.2016.06.098
  9. Anantha Narayanan M, Reddy YN, Sundaram V, et al. What is the optimal approach to a non- culprit stenosis after ST-elevation myocardial infarction - Conservative therapy or upfront revascularization? An updated meta-analysis of randomized trials. Int J Cardiol 2016;216:18-24. https://doi.org/10.1016/j.ijcard.2016.04.054
  10. Baber U, Mehran R, Sharma SK, et al. Impact of the everolimus-eluting stent on stent thrombosis: a meta-analysis of 13 randomized trials. J Am Coll Cardiol 2011;58:1569-77. https://doi.org/10.1016/j.jacc.2011.06.049
  11. Palmerini T, Biondi-Zoccai G, Della Riva D, et al. Stent thrombosis with drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis. Lancet 2012;379:1393-402. https://doi.org/10.1016/S0140-6736(12)60324-9
  12. Raber L, Magro M, Stefanini GG, et al. Very late coronary stent thrombosis of a newer-generation everolimus-eluting stent compared with early-generation drug-eluting stents: a prospective cohort study. Circulation 2012;125:1110-21. https://doi.org/10.1161/CIRCULATIONAHA.111.058560
  13. Cutlip DE, Windecker S, Mehran R, et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007;115:2344-51. https://doi.org/10.1161/CIRCULATIONAHA.106.685313
  14. Mauri L, Kereiakes DJ, Yeh RW, et al. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 2014;371:2155-66. https://doi.org/10.1056/NEJMoa1409312
  15. Nordmann AJ, Briel M, Bucher HC. Mortality in randomized controlled trials comparing drug-eluting vs. bare metal stents in coronary artery disease: a meta-analysis. Eur Heart J 2006;27:2784-814. https://doi.org/10.1093/eurheartj/ehl282
  16. Ong AT, McFadden EP, Regar E, de Jaegere PP, van Domburg RT, Serruys PW. Late angiographic stent thrombosis (LAST) events with drug-eluting stents. J Am Coll Cardiol 2005;45:2088-92. https://doi.org/10.1016/j.jacc.2005.02.086
  17. Navarese EP, Kubica J, Castriota F, et al. Safety and efficacy of biodegradable vs. durable polymer drug-eluting stents: evidence from a meta-analysis of randomised trials. EuroIntervention 2011;7:985-94. https://doi.org/10.4244/EIJV7I8A155
  18. Di Lorenzo E, Sauro R, Varricchio A, et al. Randomized comparison of everolimus-eluting stents and sirolimus-eluting stents in patients with ST elevation myocardial infarction: RACES-MI trial. JACC Cardiovasc Interv 2014;7:849-56.
  19. Sarno G, Lagerqvist B, Nilsson J, et al. Stent thrombosis in new-generation drug-eluting stents in patients with STEMI undergoing primary PCI: a report from SCAAR. J Am Coll Cardiol 2014;64:16-24. https://doi.org/10.1016/j.jacc.2014.04.022
  20. Giustino G, Baber U, Stefanini GG, et al. Impact of clinical presentation (stable angina pectoris vs unstable angina pectoris or non-ST-elevation myocardial infarction vs ST-elevation myocardial infarction) on long-term outcomes in women undergoing percutaneous coronary intervention with drug-eluting stents. Am J Cardiol 2015;116:845-52. https://doi.org/10.1016/j.amjcard.2015.06.010
  21. Di Lorenzo E, Sauro R, Capasso M, et al. Long-term results of the randomized comparison of everolimus-eluting stents and sirolimus-eluting stent in patients with ST elevation myocardial infarction (RACES-MI trial). Int J Cardiol 2016;202:177-82. https://doi.org/10.1016/j.ijcard.2015.08.123
  22. Politi L, Sgura F, Rossi R, et al. A randomised trial of target-vessel versus multi-vessel revascularisation in ST-elevation myocardial infarction: major adverse cardiac events during long-term follow-up. Heart 2010;96:662-7. https://doi.org/10.1136/hrt.2009.177162
  23. Di Mario C, Mara S, Flavio A, et al. Single vs multivessel treatment during primary angioplasty: results of the multicentre randomised HEpacoat for cuLPrit or multivessel stenting for Acute Myocardial Infarction (HELP AMI) Study. Int J Cardiovasc Intervent 2004;6:128-33. https://doi.org/10.1080/14628840310030441
  24. Thiele H, Akin I, Sandri M, et al. PCI strategies in patients with acute myocardial infarction and cardiogenic shock. N Engl J Med 2017;377:2419-32. https://doi.org/10.1056/NEJMoa1710261
  25. Yu X, Li Y, Wang Q, Liang M, Xu K, Han Y. "One-time" versus staged multivessel intervention in intermediate to very high-risk patients with non-ST-segment elevation acute coronary syndromes. Korean Circ J 2016;46:774-83. https://doi.org/10.4070/kcj.2016.46.6.774

피인용 문헌

  1. Multivessel Versus Culprit-Only Revascularization in STEMI and Multivessel Coronary Artery Disease : Meta-Analysis of Randomized Trials vol.13, pp.13, 2020, https://doi.org/10.1016/j.jcin.2020.04.055