Follow up of Complete Revascularization versus Culprit Revascularization in ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention
Objectives: To compare between only Culprit revascularization versus total revascularization in patients with ST-elevation myocardial infarction undergoing primary PCI with 6 months follow up of occurrence of major adverse cardiovascular events (MACCE). Methods: 50 patients were enrolled in this study during the period from 1/11/2018 to 1/11/2019 at Menoufiya University and national heart institute. All patients present with acute ST-elevation myocardial infarction within 24 hours of onset of symptoms, and have multi vessel coronary artery disease on angiography suitable for PCI. Patients were subjected to detailed medical history, physical examination, and electrocardiography. Results: 50 patients with acute ST-elevation myocardial infarction (28 females and 22 males) underwent primary percutaneous coronary intervention. 25 patients had total revascularization to all coronary arteries, the other 25 patients had only culprit revascularization. We found that there was a significant reduction in the incidence of recurrent chest pain and non-fatal Myocardial infarction in the total revascularization group. Conclusion: Our study showed that Multivessel revascularization resulted in an improved clinical course and a significant reduction of MACCE regarding non-fatal MI and a significant reduction of recurrent chest pain.
References
[1]
Addala, C.L. Grines, C.L., Dixon, S.R., et al. (2004) Predicting Mortality in Patients with ST-Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention (PAMI Risk Score). American Journal of Cardiology, 93, 629-632. https://doi.org/10.1016/j.amjcard.2003.11.036
[2]
Ali, A.S., Rybicki, B.A., Alam, M., et al. (1999) Clinical Predictors of Heart Failure in Patients with First Acute Myocardial Infarction. American Heart Journal, 138, 1133-1139. https://doi.org/10.1016/S0002-8703(99)70080-3
[3]
Alidoosti, M., Salarifar, M., Hajizeinale, A., et al. (2007) Outcomes of Primary Percutanous Coronary Intervention in Acute Myocardial Infarction at Tehran Center. Medical Principles and Practice, 16, 333-338. https://doi.org/10.1159/000104804
[4]
Alpert, J.S., Thygesen, K., Antman, E., et al. (2000) Myocardial Infarction Redefined a Consensus Document of the Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. Journal of the American College of Cardiology, 36, 959-969.
https://doi.org/10.1016/S0735-1097(00)00804-4
[5]
Andersen, H.R., Nielsen, T.T., Rasmussen, K., et al. (2003) A Comparison of Coronary Angioplasty with Fibrinolytic Therapy in Acute Myocardial Infarction. The New England Journal of Medicine, 349, 733-742.
https://doi.org/10.1056/NEJMoa025142
[6]
Antman, E.M. and Braunwald, E. (2001) Acute Myocardial Infarction. In: Braunwald, E., Zipes, D.P. and Libby, P., Eds., Heart Disease: A Textbook of Cardiovascular Medicine, 6th Edition, WB Saunders Co Ltd., Philadelphia, PA, 1114-1251.
[7]
Antman, E.M., Anbe, D.T., Armstrong, P.W., et al. (2008) ACC/AHA Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction. Journal of the American College of Cardiology, 51, 210-247.
https://doi.org/10.1016/j.jacc.2007.10.001
[8]
Maroko, P.R., Advany, P., Braunwald, E. and Hale, S.L. (1975) Reduction of Infarct Size by Oxygen Inhalation Following Acute Coronary Occlusion. Circulation, 52, 360-368. https://doi.org/10.1161/01.CIR.52.3.360
[9]
McNulty, P.H., Robertson, B., et al. (2007) Effect of Hyperoxia and Vitamin C on Coronary Blood Flow in Patients with Ischemic Heart Disease. Journal of Applied Physiology, 102, 2040-2045. https://doi.org/10.1152/japplphysiol.00595.2006
[10]
Meerkin, D., Tardif, J.C., Bertrandof, O.F., et al. (2000) The Effects of Intracoronary Brachytherapy on the Natural History of Postangioplasty Dissections. Journal of the American College of Cardiology, 36, 59-64.
https://doi.org/10.1016/S0735-1097(00)00678-1
[11]
Mehran, R., Aymong, E.D., Nikolsky, E., et al. (2004) A Simple Risk Score for Prediction of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention: Development and Initial Validation. Journal of the American College of Cardiology, 44, 1393-1399. https://doi.org/10.1016/S0735-1097(04)01445-7
[12]
Mehta, R.H., Harjai, K.J., Cox, D., et al. (2003) Clinical and Angiographic Correlates and Outcomes of Suboptimal Coronary Flow in Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Journal of the American College of Cardiology, 42, 1739-1743.
https://doi.org/10.1016/j.jacc.2003.07.012
[13]
Mehta, R.H., Harjai, K.J., Grines, L., et al. (2004) Sustained Ventricular Tachycardia or Fibrillation in the Cardiac Catheterization Laboratory among Patients Receiving Primary Percutaneous Coronary Intervention: Incidence, Predictors, and Outcomes. Journal of the American College of Cardiology, 43, 1765-1772.
https://doi.org/10.1016/j.jacc.2003.09.072
[14]
Menon, V., Harrington, R.A., Hochman, J.S., et al. (2004) Thrombolysis and Adjunctive Therapy in Acute Myocardial Infarction: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest, 126, 549S-575S.
https://doi.org/10.1378/chest.126.3_suppl.549S
[15]
O’Gara, P.T., Kushna, F.G., Ascheim, D.D., et al. (2013) ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 127, 529-555.
https://doi.org/10.1161/CIR.0b013e3182742c84
[16]
Gershlick, A.H., Khan, J.N., Kelly, D.J., Greenwood, J.P., Sasikaran, T., Curzen, N., et al. (2015) Randomized Trial of Complete versus Lesion-Only Revascularization invention for STEMI and Multivessel Disease: The CvLPRIT Trial. Journal of the American College of Cardiology, 65, 963-972.
https://doi.org/10.1016/j.jacc.2014.12.038
[17]
Sorajja, P., Gersh, B.J., Cox, D.A., et al. (2017) Impact of Multivessel Disease on Reperfusion Success and Clinical Outcomes in Patients Undergoing Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction. European Heart Journal, 28, 1709-1716. https://doi.org/10.1093/eurheartj/ehm184
