Comparison of Different Timing of Multivessel Intervention During Index-Hospitalization for Patients With Acute Myocardial Infarction
Background: Many patients presenting with acute myocardial infarction (AMI) were found to have a multivessel disease. Uncertainty still exists in the optimal revascularization strategy in AMI patients. The purpose of this study was to assess the outcome of immediate multivessel revascularization com...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-06-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.639750/full |
| _version_ | 1828144748559335424 |
|---|---|
| author | En-Shao Liu Cheng Chung Hung Cheng-Hung Chiang Cheng-Hung Chiang Cheng-Hung Chiang Chia-His Chang Chin-Chang Cheng Feng-You Kuo Guang-Yuan Mar Wei-Chun Huang Wei-Chun Huang Wei-Chun Huang Wei-Chun Huang |
| author_facet | En-Shao Liu Cheng Chung Hung Cheng-Hung Chiang Cheng-Hung Chiang Cheng-Hung Chiang Chia-His Chang Chin-Chang Cheng Feng-You Kuo Guang-Yuan Mar Wei-Chun Huang Wei-Chun Huang Wei-Chun Huang Wei-Chun Huang |
| author_sort | En-Shao Liu |
| collection | DOAJ |
| description | Background: Many patients presenting with acute myocardial infarction (AMI) were found to have a multivessel disease. Uncertainty still exists in the optimal revascularization strategy in AMI patients. The purpose of this study was to assess the outcome of immediate multivessel revascularization compared with staged multivessel percutaneous coronary intervention (PCI) in patients with AMI.Method: This was a nationwide cohort study of 186,112 patients first diagnosed with AMI, 78,699 of whom received PCI for revascularization. Patients who received repetitive PCI during the index hospitalization were referred to as staged multivessel PCI. Immediate multivessel PCI was defined as patients with two-vessel PCI or three-vessel PCI during the index procedure. Cox proportional hazards regression models were performed to evaluate the different indicators of mortality risks in AMI.Result: Immediate multivessel PCI was associated with a worse long-term outcome than staged multivessel PCI during the index admission (log-rank P < 0.001). There was a higher incidence of stroke in patients with multivessel PCI during hospitalization. In Cox analysis, immediate multivessel PCI was an independent risk factor for mortality compared to those with staged multivessel PCI, regardless of the type of myocardial infarction.Conclusion: This study demonstrated that performing immediate multivessel PCI for AMI may lead to worse long-term survival than staged multivessel PCI. Our findings emphasized the importance of PCI timing for non-infarct-related artery stenosis and provided information to supplement current evidence. |
| first_indexed | 2024-04-11T20:21:35Z |
| format | Article |
| id | doaj.art-744064d6e24644a19a32b11acf856dfe |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T20:21:35Z |
| publishDate | 2021-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-744064d6e24644a19a32b11acf856dfe2022-12-22T04:04:48ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-06-01810.3389/fcvm.2021.639750639750Comparison of Different Timing of Multivessel Intervention During Index-Hospitalization for Patients With Acute Myocardial InfarctionEn-Shao Liu0Cheng Chung Hung1Cheng-Hung Chiang2Cheng-Hung Chiang3Cheng-Hung Chiang4Chia-His Chang5Chin-Chang Cheng6Feng-You Kuo7Guang-Yuan Mar8Wei-Chun Huang9Wei-Chun Huang10Wei-Chun Huang11Wei-Chun Huang12Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Physical Therapy, Fooyin University, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanSchool of Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Physical Therapy, Fooyin University, Kaohsiung, TaiwanGraduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanBackground: Many patients presenting with acute myocardial infarction (AMI) were found to have a multivessel disease. Uncertainty still exists in the optimal revascularization strategy in AMI patients. The purpose of this study was to assess the outcome of immediate multivessel revascularization compared with staged multivessel percutaneous coronary intervention (PCI) in patients with AMI.Method: This was a nationwide cohort study of 186,112 patients first diagnosed with AMI, 78,699 of whom received PCI for revascularization. Patients who received repetitive PCI during the index hospitalization were referred to as staged multivessel PCI. Immediate multivessel PCI was defined as patients with two-vessel PCI or three-vessel PCI during the index procedure. Cox proportional hazards regression models were performed to evaluate the different indicators of mortality risks in AMI.Result: Immediate multivessel PCI was associated with a worse long-term outcome than staged multivessel PCI during the index admission (log-rank P < 0.001). There was a higher incidence of stroke in patients with multivessel PCI during hospitalization. In Cox analysis, immediate multivessel PCI was an independent risk factor for mortality compared to those with staged multivessel PCI, regardless of the type of myocardial infarction.Conclusion: This study demonstrated that performing immediate multivessel PCI for AMI may lead to worse long-term survival than staged multivessel PCI. Our findings emphasized the importance of PCI timing for non-infarct-related artery stenosis and provided information to supplement current evidence.https://www.frontiersin.org/articles/10.3389/fcvm.2021.639750/fullacute myocardial infarctionmultivessel percutaneous coronary interventionnon-ST elevation myocardial infarctionnon-infarct-related arterypercutaneous coronary interventionST-segment elevation myocardial infarction |
| spellingShingle | En-Shao Liu Cheng Chung Hung Cheng-Hung Chiang Cheng-Hung Chiang Cheng-Hung Chiang Chia-His Chang Chin-Chang Cheng Feng-You Kuo Guang-Yuan Mar Wei-Chun Huang Wei-Chun Huang Wei-Chun Huang Wei-Chun Huang Comparison of Different Timing of Multivessel Intervention During Index-Hospitalization for Patients With Acute Myocardial Infarction Frontiers in Cardiovascular Medicine acute myocardial infarction multivessel percutaneous coronary intervention non-ST elevation myocardial infarction non-infarct-related artery percutaneous coronary intervention ST-segment elevation myocardial infarction |
| title | Comparison of Different Timing of Multivessel Intervention During Index-Hospitalization for Patients With Acute Myocardial Infarction |
| title_full | Comparison of Different Timing of Multivessel Intervention During Index-Hospitalization for Patients With Acute Myocardial Infarction |
| title_fullStr | Comparison of Different Timing of Multivessel Intervention During Index-Hospitalization for Patients With Acute Myocardial Infarction |
| title_full_unstemmed | Comparison of Different Timing of Multivessel Intervention During Index-Hospitalization for Patients With Acute Myocardial Infarction |
| title_short | Comparison of Different Timing of Multivessel Intervention During Index-Hospitalization for Patients With Acute Myocardial Infarction |
| title_sort | comparison of different timing of multivessel intervention during index hospitalization for patients with acute myocardial infarction |
| topic | acute myocardial infarction multivessel percutaneous coronary intervention non-ST elevation myocardial infarction non-infarct-related artery percutaneous coronary intervention ST-segment elevation myocardial infarction |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.639750/full |
| work_keys_str_mv | AT enshaoliu comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT chengchunghung comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT chenghungchiang comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT chenghungchiang comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT chenghungchiang comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT chiahischang comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT chinchangcheng comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT fengyoukuo comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT guangyuanmar comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT weichunhuang comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT weichunhuang comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT weichunhuang comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction AT weichunhuang comparisonofdifferenttimingofmultivesselinterventionduringindexhospitalizationforpatientswithacutemyocardialinfarction |