Multivessel percutaneous coronary intervention in patients with acute myocardial infarction and severe renal dysfunction

KAMIR-NIH Registry Investigators

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aims: The aim of this study was to compare the outcomes between multivessel and infarct-related artery (IRA)-only percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), multivessel disease (MVD), and severe renal dysfunction (RD) using the nationwide AMI registry. Methods and results: Among 13,104 patients, 537 diagnosed with AMI and MVD who had severe RD at presentation (estimated glomerular filtration rate [GFR] <30 mL/min/1.73 m2, mean: 19.1±7.5 mL/ min/1.73 m2) and underwent PCI during index hospitalisation were selected. The patients were classified according to treatment strategy, i.e., multivessel PCI (49.0%) or IRA-only PCI. The primary endpoint was major adverse cardiac events (MACE), a composite of all-cause death, myocardial reinfarction, re-hospitalisation for heart failure, and any repeat revascularisation at one year. The safety outcome was the worsening of renal function (WRF), defined as a 30% reduction in estimated GFR from baseline to 12-month followup. The adjusted MACE risks were similar in groups after Cox regression (41.8% vs 39.8%, hazard ratio [HR] 1.008 [0.743-1.367]) and propensity score-matching analysis (HR 0.974 [0.651-1.377]). Multivessel PCI showed a significant tendency of higher rates of WRF (24.8% vs 11.1%, adjusted odds ratio 2.134 [0.976-4.668]). Conclusions: Multivessel PCI was associated with similar outcomes compared to IRA-only PCI in patients with AMI, MVD, and severe RD.

Original languageEnglish
Pages (from-to)E1014-E1021
JournalEuroIntervention
Volume15
Issue number11
DOIs
Publication statusPublished - 2019 Dec

Keywords

  • Multiple vessel disease
  • Non-STEMI
  • Renal insufficiency
  • STEMI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Multivessel percutaneous coronary intervention in patients with acute myocardial infarction and severe renal dysfunction'. Together they form a unique fingerprint.

  • Cite this