Outcomes of patients with myocardial infarction and cardiogenic shock treated with culprit vessel-only versus multivessel primary PCI.

Autor:	Hlinomaz O; International Clinical Research Center and Department of Cardioangiology, St. Anne University Hospital and Masaryk University, Brno, Czech Republic., Motovska Z; Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. Electronic address: zuzana.motovska@lf3.cuni.cz., Kala P; University Hospital Brno and Faculty of Medicine of Masaryk University, Department of Internal Medicine and Cardiology, Brno, Czech Republic., Hromadka M; University Hospital and Faculty of Medicine, Pilsen, Czech Republic., Precek J; University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic., Mrozek J; University Hospital and Faculty of Medicine, Ostrava, Czech Republic., Červinka P; Masaryk Hospital, Usti Nad Labem, Czech Republic., Kettner J; Institute of Clinical and Experimental Medicine, Prague, Czech Republic., Matejka J; Regional Hospital, Pardubice, Czech Republic., Zohoor A; Regional Hospital, Karlovy Vary, Czech Republic., Bis J; University Hospital and Faculty of Medicine, Hradec Kralové, Czech Republic., Jarkovsky J; Institute of Biostatistics and Analyses of Masaryk University, Brno, Czech Republic; Institute of Health Information and Statistics of the Czech Republic, Czech Republic.
Jazyk:	angličtina
Zdroj:	Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese [Hellenic J Cardiol] 2024 Mar-Apr; Vol. 76, pp. 1-10. Date of Electronic Publication: 2023 Aug 24.
DOI:	10.1016/j.hjc.2023.08.009
Abstrakt:	Introduction and Objectives: Multivessel primary percutaneous coronary intervention (pPCI) is still often used in patients with ST-elevation myocardial infarction (STEMI) and cardiogenic shock (CS). The study aimed to compare the characteristics and prognosis of patients with CS-STEMI and multivessel coronary disease (MVD) treated with culprit vessel-only pPCI or multivessel-pPCI during the initial procedure. Material and Methods: From 2016 to 2020, 23,703 primary PCI patients with STEMI were included in a national all-comers registry of cardiovascular interventions. Of them, 1,213 (5.1%) patients had CS and MVD at admission to the hospital. Initially, 921 (75.9%) patients were treated with culprit vessel (CV)-pPCI and 292 (24.1%) with multivessel (MV)-pPCI. Results: Patients with 3-vessel disease and left main disease had a higher probability of being treated with MV-pPCI than patients with 2-vessel disease and patients without left main disease (28.5% vs. 18.6%; p < 0.001 and 37.7% vs. 20.6%; p < 0.001). Intra-aortic balloon pump, extracorporeal membrane oxygenation (ECMO), and other mechanical circulatory support systems were more often used in patients with MV-pPCI. Thirty (30)-day and 1-year all-cause mortality rates were similar in the CV-pPCI and MV-pPCI groups (odds ratio, 1.01; 95% confidence interval [CI] 0.77 to 1.32; p = 0.937 and 1.1; 95% CI 0.84 to 1.44; p = 0.477). The presence of 3-vessel disease and the use of ECMO were the strongest adjusted predictors of 30-day and 1-year mortality. Conclusions: Our data from an extensive all-comers registry suggests that selective use of MV-pPCI does not increase the all-cause mortality rate in patients with CS-STEMI and MVD compared to CV-pPCI. (Copyright © 2023 Hellenic Society of Cardiology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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