Effect of revascularization strategy in patients with acute myocardial infarction and renal insufficiency with multivessel disease
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Background/Aims: The aim of this study was to compare the risk of complicationsand outcome between infarct-related artery (IRA)-only revascularizationand multivessel (MV) revascularization in patients with acute myocardial infarction(MI) with renal insufficiency and MV disease. Methods: A total of 1,031 acute MI patients with renal insufficiency and MV diseasewho were registered in the Korea Working Group on Myocardial Infarctionwere enrolled. They were divided into two groups (IRA-only revascularizationgroup, n = 404; MV revascularization group, n = 627), and investigated the cumulativeincidence of major adverse cardiac events (MACE) and the incidence of complicationsafter percutaneous coronary intervention (PCI). Results: Complications after PCI occurred in 19.9% of all patients (206/1,031). Complications after PCI occurred more frequently in the MV revascularizationgroup compared with the IRA-only revascularization group (20.1% [126/627] vs. 15.3% [62/404], respectively; p = 0.029]. The overall in-hospital mortality rate was6.3%, and there was no significant difference between the groups (5.2% in theIRA-only revascularization group vs. 7.0% in the MV revascularization group;p = 0.241). The total incidence of MACE was 11.1%, and there was no significantdifference between the groups (11.6% in the IRA-only revascularization group vs. 10.7% in the MV revascularization group; p = 0.636). Conclusions: The incidence of complications after PCI was significantly lower inthe IRA-only revascularization group compared with the MV revascularizationgroup. However, there were no significant difference in the 12-month outcomesbetween groups in patients with acute MI and renal insufficiency with MV disease.
Abstract
Background/Aims: The aim of this study was to compare the risk of complicationsand outcome between infarct-related artery (IRA)-only revascularizationand multivessel (MV) revascularization in patients with acute myocardial infarction(MI) with renal insufficiency and MV disease. Methods: A total of 1,031 acute MI patients with renal insufficiency and MV diseasewho were registered in the Korea Working Group on Myocardial Infarctionwere enrolled. They were divided into two groups (IRA-only revascularizationgroup, n = 404; MV revascularization group, n = 627), and investigated the cumulativeincidence of major adverse cardiac events (MACE) and the incidence of complicationsafter percutaneous coronary intervention (PCI). Results: Complications after PCI occurred in 19.9% of all patients (206/1,031). Complications after PCI occurred more frequently in the MV revascularizationgroup compared with the IRA-only revascularization group (20.1% [126/627] vs. 15.3% [62/404], respectively; p = 0.029]. The overall in-hospital mortality rate was6.3%, and there was no significant difference between the groups (5.2% in theIRA-only revascularization group vs. 7.0% in the MV revascularization group;p = 0.241). The total incidence of MACE was 11.1%, and there was no significantdifference between the groups (11.6% in the IRA-only revascularization group vs. 10.7% in the MV revascularization group; p = 0.636). Conclusions: The incidence of complications after PCI was significantly lower inthe IRA-only revascularization group compared with the MV revascularizationgroup. However, there were no significant difference in the 12-month outcomesbetween groups in patients with acute MI and renal insufficiency with MV disease.
참고문헌 (29)
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