Purpose
For patients (pts) who present an acute myocardial infarction (STEMI), the benefit of PCI in culprit lesion is clearly demonstrated. Regarding this population, around 40% of pts had multivessel diseases (MVD) (two or more). Except for cardiogenic shock, the results of PCI on nonculprit lesion is not clearly known in real life. This study aims at determining the results and intrahospital prognosis for a selected population of STEMI with MVD.
Methods
We analyzed data collected in the “Observatoire Régional Breton sur l’Infarctus (ORBI),” a registry of all pts admitted to an interventional cardiology center in Brittany in the acute phase of a STEMI. Patients with cardiogenic shock or Killip 3 at admission were excluded. Main clinical data and intrahospital outcome were compared between ORBI pts requiring PCI in only one culprit lesion without other lesion (group 1: 1613 pts), those who required PCI in others lesions because of a recurrent ischemia (group 2: 109 patients) and those with MVD with no other PCI before discharge (group 3: 1146 pts).
Methods
We analyzed data collected in the “Observatoire Régional Breton sur l’Infarctus (ORBI),” a registry of all pts admitted to an interventional cardiology center in Brittany in the acute phase of a STEMI. Patients with cardiogenic shock or Killip 3 at admission were excluded. Main clinical data and intrahospital outcome were compared between ORBI pts requiring PCI in only one culprit lesion without other lesion (group 1: 1613 pts), those who required PCI in others lesions because of a recurrent ischemia (group 2: 109 patients) and those with MVD with no other PCI before discharge (group 3: 1146 pts).
Results
Among 2700 pts included in the ORBI registry, 109 pts (group 2) required a new PCI, only proposed if the nonculprit lesion is at low rate of complication (type A or B1). Indications of new PCI were recurrent ischemia (4.6%), angiographic aspect of lesions (81.4%) and positive exercise test (14%). The culprit lesion were treated by a DES in 12.7% and the others lesions with a DES in 35%. Main clinical data regarding age, sex and risk factors are nonsignificant between groups 1 and 2 or 2 and 3. The mean delay between the two PCIs was 6.1±3.6 days. Major events were nonsignificantly higher in group 2 compared to the other groups.
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