Single or multivessel percutaneous coronary intervention in ST‐elevation myocardial infarction patients

Abstract

Objectives: To evaluate clinical results of percutaneous coronary intervention (PCI) in ST‐elevation myocardial infarction (STEMI) in patients with multivessel disease (MVD), in relation to single or multivessel (MV)‐PCI and to patients with single vessel disease (SVD). Methods: Patients treated with PCI in the setting of P = 0.007), new revascularization 2.9% and 9%, respectively (P < 0.001). Thirty‐day mortality was 2.4% in SVD and 6.7% in MVD (P = 0.006). After exclusion of patients with cardiogenic shock or pulmonary oedema, more frequent in the MV‐PCI in single session group (P = 0.006), 30‐day mortality was SVD 1.3%, IRA‐only 6.3%, MV‐PCI 2.8% (P = 0.023), without differences if in a single (3.3%) or in staged session (2.2%). By multivariate analysis, female sex, anterior STEMI, cardiogenic shock, MVD, and procedural failure were independent predictors of 30‐day mortality. Conclusions: STEMI patients with MVD have a worse prognosis than those with SVD. MV‐PCI in patients without hemodynamic compromise yields good short‐term results, even if performed very early, with a 30‐day mortality in between that of SVD patients and that of MVD patients with IRA‐only treatment.