RETRACTED ARTICLE- see notice (http://icfjournal.org/index.php/icfj/announcement/view/5) Comparative Effectiveness of Complete Revascularization versus Infarct Related Artery-only Percutaneous Coronary Revascularization .....

Joshua Chadwick Jayaraj, Lusine Abrahamyan, Anahit Demirchyan

Abstract


Objectives: The purpose of this study was to evaluate the event free survival from major adverse cardiac events (MACE) for ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease as a function of whether they underwent infarct-related artery (IRA) only percutaneous coronary intervention (PCI) or complete revascularization at index admission.

Background: The optimal management of patients with STEMI and multivessel disease while undergoing primary percutaneous coronary intervention (P-PCI) is uncertain.

Methods and Results: STEMI patients with multivessel disease undergoing P-PCI between April 1, 2012, and March 31, 2014, were subdivided into those who underwent in-hospital complete revascularization (n= 150) or IRA-only revascularization (n = 156). Complete revascularization was performed during the index admission of P-PCI. The primary endpoint was a composite of all-cause death, recurrent myocardial infarction (MI), heart failure, and ischemia-driven revascularization within 24 months. Patient groups were differed at baseline by gender and prevalence of heart failure. The average door-to-balloon time was significantly higher in the complete revascularization group. The primary endpoint occurred in 11.0% of the complete revascularization group versus 23% in the IRA-only revascularization group (hazard ratio: 0.51; 95% confidence interval: 0.34 to 0.93; p =0.039). There was a significant reduction in death, a non-significant reduction in all primary endpoint components was seen.

Conclusions: In patients presenting for P-PCI with multivessel disease, index admission complete revascularization significantly lowered the rate of the primary composite endpoint at 24 months compared with treating only the IRA. 

Keywords


complete revascularization; infarct-related artery only; primary percutaneous coronary angioplasty; ST-segment elevation patients; multi-vessel disease patients;

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DOI: https://doi.org/10.17987/icfj.v8i0.256

Copyright (c) 2016 Joshua Chadwick Jayaraj, Lusine Abrahamyan, Anahit Demirchyan

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