Journal
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
Volume 6, Issue 7, Pages 592-600Publisher
OXFORD UNIV PRESS
DOI: 10.1177/2048872615624240
Keywords
ST-elevation myocardial infarction; multivessel coronary artery disease; reperfusion success; cardiac magnetic resonance imaging
Categories
Ask authors/readers for more resources
Background: A significant portion of patients with ST-elevation myocardial infarction (STEMI) display multivessel coronary artery disease. However, data on the association of multivessel coronary artery disease and reperfusion success are scarce. The aim of the current study was to analyse the impact of multivessel coronary artery disease on myocardial salvage assessed by cardiac magnetic resonance imaging in a large unselected cohort of STEMI patients. Methods: STEMI patients (n=738) included in the AIDA STEMI trial underwent primary percutaneous coronary intervention within 12 hours after symptom onset. Cardiac magnetic resonance imaging was performed 3 days after the index event (interquartile range (IQR) 2-4). The severity of coronary artery disease was graded as single-vessel disease compared to multivessel disease. The primary endpoint was defined as a composite of death, non-fatal myocardial re-infarction and congestive heart failure (major adverse cardiac events) at 12 months. Results: Multivessel coronary artery disease was present in 46.3% (n=342) of all patients. Patients with multivessel coronary artery disease were older and more often had diabetes in comparison to those with single-vessel disease (P<0.001 and P=0.005). Angiographic and electrocardiographic reperfusion success defined as Thrombolysis in Myocardial Infarction flow III post-percutaneous coronary intervention and ST-segment resolution 70% were similar between both groups (P=0.48 and P=0.21). Patients with multivessel disease displayed no significant difference with respect to myocardial salvage index (49.8 (IQR 31.4-71.6) versus 52.7 (IQR 35.1-67.1), P=0.81) in comparison to patients with single-vessel disease. The presence of multivessel coronary artery disease was identified as an independent predictor for the time-dependent occurrence of major adverse cardiac events (hazard ratio 3.25, 95% confidence interval 1.53-6.91, P=0.002). Conclusion: Although multivessel coronary artery disease is not associated with impaired reperfusion success assessed by cardiac magnetic resonance imaging, patients with multivessel disease are at a high risk of adverse clinical outcomes.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available