ISSN 2149-2263 | E-ISSN 2149-2271
Volume : 25 Issue : 11 Year : 2021
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The Anatolian Journal of Cardiology A clinical trial comparing complete revascularization at the time of primary percutaneous coronary intervention versus during the index hospital admission in patients with multi-vessel coronary artery disease and STEMI uncomplicated by cardiogenic shock [Anatol J Cardiol]
Anatol J Cardiol. 2021; 25(11): 781-788 | DOI: 10.5152/AnatolJCardiol.2021.71080

A clinical trial comparing complete revascularization at the time of primary percutaneous coronary intervention versus during the index hospital admission in patients with multi-vessel coronary artery disease and STEMI uncomplicated by cardiogenic shock

Mihnea Traian Nichita Brendea1, Mircea I. Popescu2, Virgil Popa1, Polojintef Corbu Dorina Carmen2
1Department of Cardiology, Emergency Clinical County Hospital; Oradea-Romania
2Department of Cardiology, Emergency Clinical County Hospital; Oradea-Romania;Department of Medical Disciplines, Faculty of Medicine and Pharmacology, University of Oradea; Oradea-Romania

Objective: In this study, we aimed to compare major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of death, stroke, myocardial infarction and symptom-induced revascularization, and mortality within one year of randomization between two strategies; complete revascularization including non-culprit lesions percutaneous coronary intervention (PCI) during primary PCI (PPCI) versus complete revascularization during the same hospital admission in patients with multi-vascular coronary artery disease (MVD) presenting with ST-elevation myocardial infarction (STEMI) uncomplicated by cardiogenic shock.
Methods: We randomized in a 1: 1 manner 100 patients with MVD and STEMI uncomplicated by cardiogenic shock who had undergone successful culprit-lesion PCI to either a strategy of complete revascularization with PCI of angiographically significant non-culprit lesions in the index PPCI procedure or to a strategy of complete revascularization during a second procedure that took place during the same hospital admission.
Results: The first primary outcome was death within a timeframe of one year and the second a composite of MACCE within a year following complete revascularization. Of the total number of patients monitored, 4% in each of the two groups was associated with the first primary outcome (p=0.984) and the second primary outcome in 6% (p=0.970). There was no statistical difference between outcomes in the two groups.
Conclusion: Among patients with MVD and STEMI uncomplicated by cardiogenic shock, there was no difference regarding outcomes when using a strategy of complete revascularization of non-culprit lesions during PPCI or the same hospital admission.

Keywords: primary percutaneous coronary intervention, multi-vessel coronary artery disease, ST-elevation myocardial infarction

Mihnea Traian Nichita Brendea, Mircea I. Popescu, Virgil Popa, Polojintef Corbu Dorina Carmen. A clinical trial comparing complete revascularization at the time of primary percutaneous coronary intervention versus during the index hospital admission in patients with multi-vessel coronary artery disease and STEMI uncomplicated by cardiogenic shock. Anatol J Cardiol. 2021; 25(11): 781-788

Corresponding Author: Mihnea Traian Nichita Brendea, Romania
Manuscript Language: English