Multivessel Disease As A Prognostic Factor For Mortality In STEMI Patients

Abstract

Summary The main objective of this analysis was to define the influence of multivessel disease involvement compared to single vessel disease on mortality rates in STEMI patients. The retrospective study included 549 patients, hospitalized with STEMI in St. Ekaterina University Hospital (age - 62.66±12.56; women - 31.3%) from 01.06.2008 to 30.06.2011. One-vessel disease was found in 232 patients (44%) as compared to two-vessel disease in 165 patients - 31% and multivessel disease in 130 patients - 25%. There was LM stenosis (>30) in 11 patients (2%); ostial lesion in 33 patients (6.3%); presence of Ca in 37 patients (7%). A stent was implanted in 484 patients (91.8%), and GP IIb/IIIa was used in 400 patients (75.9%). There was significant increase in mortality rates in patients with multivessel disease: 15.6% - 46 patients, compared to one-vessel disease - 6.5% (15 patients) (p<=0.01). Both early (30 days) and late mortality (one year) rates were higher in the multivessel group (6.8% vs. 2.6%, p<=0.05 and 10.2% vs. 3.9% (p<=0.0510), respectively. Multivessel disease is associated with higher mortality rates in STEMI patients, which may further alter clinical course and decision making.

Multivessel Coronary Artery Disease and Subsequent Thrombolysis in Myocardial Infarction Flow Grade After Primary Percutaneous Coronary Intervention

“…Multivessel involvement in patients with STEMI is not an uncommon finding; 50% MVD in our study is aligned with the reported frequency of as high as 44% to 66% in patients with STEMI [10][11][12]14,15]. MVD has been proven to be a significant prognostic marker with significantly higher rates of associated morbidities and mortalities [10][11][12]. Multivessel involvement is found to be associated with various clinical and demographic factors such that patients with MVD are older in age as compared to patients with SVD, comorbid conditions such as HTN and DM are more common, and patients with MVD have more complex and severe diseases with a higher proportion of type C lesions and a higher thrombus grade [10,12,14,16,17].…”

“…Multivessel involvement in patients with STEMI is not an uncommon finding; 50% MVD in our study is aligned with the reported frequency of as high as 44% to 66% in patients with STEMI [10][11][12]14,15]. MVD has been proven to be a significant prognostic marker with significantly higher rates of associated morbidities and mortalities [10][11][12].…”

“…According to multiple studies involving clinical trials and institutional registries, multivessel CAD (MVD) was documented in around half of the patients with acute myocardial infarction (AMI). CAD involving multiple vessels has been linked to increased chances of mortality and morbidity amongst patients suffering from the disease [10][11][12].…”

Complete interventional revascularization versus infarct-related artery revascularization only in stemi patients – part I

“…В контраст с широкодостъпната и добре разработена интервенционална мрежа с установени практики за първична ПКИ, проследяването на нашите като цяло високорискови пациенти впоследствие е неясно. Дългосрочният ефект от предприетите интервенционални терапевтични стратегии също остава с въпросителна [45][46][47]. У нас поетапната планова реваскуларизация безспорно е част от рутинната практика, особено в големите центрове и в нискорисковите популации пациенти.…”

“…У нас поетапната планова реваскуларизация безспорно е част от рутинната практика, особено в големите центрове и в нискорисковите популации пациенти. Проследените и публикувани резултати за тази актуална за нас популация, включваща вероятно по-широк рис ков спектър пациенти в сравнение с рандомизираните проучвания в световен мащаб, са все още епизодични и оскъдни [47][48][49]. Установяването на тенденциите, успехите и пропуските в локалната клинична практика е съществена стъпка в изготвянето на прицелни здравни политики, както и в насочване на усилията на специалистите към ефективни терапевтични подходи при проследяването на пациентите с преживян SТЕМI.…”