摘要
Background Rapid recanalization of infarct-related artery （IRA） has become the major target during primary percutaneous coronary intervention （PCI） for patients with ST-elevation myocardial infarction （MI）, but strategy for treatment of non-IRA lesions in this setting remains unclear. This study aimed to compare long-term effects between PCI for IRA only and that for both IRA and non-IRA in ST-elevation MI patients with multi-vessel disease.Methods A total of 242 eligible patients with ST-elevation MI and at least two diseased coronary arteries （luminal narrowing 〉70%） undergoing primary PCI were included. Of them, 149 patients underwent primary PCI for IRA only （group 1）, and 93 received primary PCI for IRA followed by elective PCI for non-IRA 7 to 15 days after acute myocardial infarction （AMI） （group 2）. Drug-eluting stents （DESs） were deployed in more than 90% of the patients. Results The two groups did not differ with respect to baseline clinical and angiographic characteristics. No significant differences were observed in 12-month clinical follow-up results regarding major adverse cardiac events （11.5% vs 15.1%, P 〉0.05） and target lesion revascularization （8.1% vs 7.6%, P 〉0.05） between the two groups. However, patients in group 1 had higher rates of recurrent angina （10.1% vs 2.1%, P 〈0.05） and depressed left ventricular ejection fraction evaluated by echocardiography （0.56±0.22 vs 0.63±0.25, P 〈0.05）. Conclusion With the use of DESs, complete revascularization with elective PCI for non-IRA after primary PCI may exert a beneficial effect on long-term symptomatology and left ventricular function in patients with ST-elevation Mt and multi-vessel disease.
Background Rapid recanalization of infarct-related artery （IRA） has become the major target during primary percutaneous coronary intervention （PCI） for patients with ST-elevation myocardial infarction （MI）, but strategy for treatment of non-IRA lesions in this setting remains unclear. This study aimed to compare long-term effects between PCI for IRA only and that for both IRA and non-IRA in ST-elevation MI patients with multi-vessel disease.Methods A total of 242 eligible patients with ST-elevation MI and at least two diseased coronary arteries （luminal narrowing 〉70%） undergoing primary PCI were included. Of them, 149 patients underwent primary PCI for IRA only （group 1）, and 93 received primary PCI for IRA followed by elective PCI for non-IRA 7 to 15 days after acute myocardial infarction （AMI） （group 2）. Drug-eluting stents （DESs） were deployed in more than 90% of the patients. Results The two groups did not differ with respect to baseline clinical and angiographic characteristics. No significant differences were observed in 12-month clinical follow-up results regarding major adverse cardiac events （11.5% vs 15.1%, P 〉0.05） and target lesion revascularization （8.1% vs 7.6%, P 〉0.05） between the two groups. However, patients in group 1 had higher rates of recurrent angina （10.1% vs 2.1%, P 〈0.05） and depressed left ventricular ejection fraction evaluated by echocardiography （0.56±0.22 vs 0.63±0.25, P 〈0.05）. Conclusion With the use of DESs, complete revascularization with elective PCI for non-IRA after primary PCI may exert a beneficial effect on long-term symptomatology and left ventricular function in patients with ST-elevation Mt and multi-vessel disease.
