Impact of complete revascularization in patients with ST-elevation myocardial infarction

Rodrigues, Gustavo; Gonçalves, Pedro de Araújo; Madeira, Sérgio; Rodrigues, Ricardo José; Santos, Mónica; Brito, João; Raposo, Luís; Gabriel, Henrique Mesquita; Teles, Rui Campante; Almeida, Manuel; Mendes, Miguel

doi:10.1097/mca.0000000000000334

Cited by 4 publications

(2 citation statements)

References 32 publications

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“…Patient information was collected in the ACROSS (Angiography and Coronary Revascularization Registry of Santa Cruz Hospital) Registry, in which demographic, clinical, angiographic, and procedure-related variables are prospectively collected using a dedicated cath-lab-based computer database as we published previously (Cardiobase; Infortucano, Lisbon, Portugal) [10].…”

Section: Study Population and Designmentioning

confidence: 99%

Low previous cardiovascular risk of patients with ST-elevation myocardial infarction

Rodrigues

Gonçalves

Costa

et al. 2017

Coronary Artery Disease

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In a population of patients with STEMI as the first manifestation of CAD, the CV risk stratification with the SCORE risk charts, if calculated before the event, would classify as low risk more than two-thirds of the patients (71.4%) and only 3.5% would be classified as very high-risk patients. The high prevalence of low-risk patients indicates the current challenge of CV risk stratification, underlying the need for additional tools in primary prevention to better identify patients at risk.

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Section: Study Population and Designmentioning

confidence: 99%

Low previous cardiovascular risk of patients with ST-elevation myocardial infarction

Rodrigues

Gonçalves

Costa

et al. 2017

Coronary Artery Disease

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“…1 It is presumed that in unstable clinical conditions full revascularisation is warranted, irrespective of the real ischaemic significance of a coronary stenosis. 2 In stable CAD revascularisation is a much more debatable issue due to the lack its effect on the hard endpoints of unselective intervention based only on the angiographic severity of a coronary stenosis.…”

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confidence: 99%

Fractional Flow Reserve Assessment of Coronary Artery Stenosis

Bălănescu¹

2016

European Cardiology Review

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revascularisation resulted from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial: any coronary stenosis >50 % that can produce myocardial ischaemia in >10 % of the left ventricular myocardium. 5,6 Many lesions of the coronary arteries fall outside these clearcut situations. Some patients have critical coronary stenoses in vessels that have no distal runoff or irrigate non-viable myocardium.

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Culprit-only versus staged complete revascularization for patients with ST-segment elevation myocardial infarction and Multivessel disease: a retrospective cohort study

Takata

Dong

Zhu

et al. 2016

BMC Cardiovasc Disord

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BackgroundMultivessel disease (MVD) is common in patients with ST-segment elevation myocardial infarction (STEMI), but optimal treatment management remains undetermined.MethodsIn this retrospective cohort study, 602 consecutive STEMI patients with MVD were enrolled between January 1, 2010 and October 1, 2014. Three hundred and eighty-two patients underwent culprit-only revascularization and 220 underwent staged complete revascularization. Primary end points were a composite of cardiac mortality or nonfatal reinfarction.ResultsThe mean duration of follow-up was 35 months (12–71 months). Following multivariate analysis, staged complete revascularization was associated with a lower rate of the composite of cardiac mortality or nonfatal reinfarction [HR: 0.430, 95 % CI: 0.197–0.940, P = 0.034] and unplanned repeat revascularization [HR: 0.343, 95 % CI: 0.166–0.708, P = 0.004] compared with culprit-only revascularization.ConclusionsCompared with culprit-only revascularization, staged complete revascularization significantly reduced the rate of the composite of cardiac mortality or nonfatal reinfarction, and the need for unplanned repeat revascularization.

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Impact of complete revascularization in patients with ST-elevation myocardial infarction

Abstract: In patients with STEMI and MVD undergoing culprit lesion PCI, preventive PCI in noninfarct coronary arteries with significant stenosis was associated with a lower risk of MACE compared with incomplete revascularization in this all-comers prospective registry.

Cited by 4 publications

References 32 publications

Low previous cardiovascular risk of patients with ST-elevation myocardial infarction

Low previous cardiovascular risk of patients with ST-elevation myocardial infarction

Fractional Flow Reserve Assessment of Coronary Artery Stenosis

Culprit-only versus staged complete revascularization for patients with ST-segment elevation myocardial infarction and Multivessel disease: a retrospective cohort study

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