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EuroIntervention, 2019. 15(11), e1014-e1021, DOI: https://doi.org/10.4244/EIJ-D-19-00034
Multivessel percutaneous coronary intervention in patients with acute myocardial infarction and severe renal dysfunction
Pil Sang Song, Joo-Yong Hahn; Hyeon-Cheol Gwon; Ki-Hyun Jeon; Cheol Woong Yu; Seung-Woon Rha; Chang-Hwan Yoon; Myung Ho Jeong
Aims: The aim of this study was to compare the outcomes between multivessel and infarct-related artery(IRA)-only percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI),multivessel disease (MVD), and severe renal dysfunction (RD) using the nationwide AMI registry.Methods and results: Among 13,104 patients, 537 diagnosed with AMI and MVD who had severeRD at presentation (estimated glomerular filtration rate [GFR] <30 mL/min/1.73 m2, mean: 19.1±7.5 mL/min/1.73 m2) and underwent PCI during index hospitalisation were selected. The patients were classifiedaccording to treatment strategy, i.e., multivessel PCI (49.0%) or IRA-only PCI. The primary endpoint wasmajor adverse cardiac events (MACE), a composite of all-cause death, myocardial reinfarction, re-hospitalisationfor heart failure, and any repeat revascularisation at one year. The safety outcome was the worseningof renal function (WRF), defined as a 30% reduction in estimated GFR from baseline to 12-month followup.The adjusted MACE risks were similar in groups after Cox regression (41.8% vs 39.8%, hazard ratio[HR] 1.008 [0.743-1.367]) and propensity score-matching analysis (HR 0.974 [0.651-1.377]). MultivesselPCI showed a significant tendency of higher rates of WRF (24.8% vs 11.1%, adjusted odds ratio 2.134[0.976-4.668]).Conclusions: Multivessel PCI was associated with similar outcomes compared to IRA-only PCI in patientswith AMI, MVD, and severe RD.
- DOI: https://doi.org/10.4244/EIJ-D-19-00034
- ISBN or ISSN: 1774-024X
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.