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Updated: Aug 9, 2026
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Long-term impact of multivessel disease on cause-specific mortality after ST elevation myocardial infarction treated
R J van der Schaaf1, J R Timmer, J P Ottervanger
1Department of Cardiology, Isala klinieken, locatie Weezenlanden, Zwolle, The Netherlands.
Insights
Multivessel coronary artery disease (MVD) increases long-term mortality in ST-elevation myocardial infarction (STEMI) patients. MVD strongly predicts heart failure deaths but not overall mortality or sudden death.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- ST-elevation myocardial infarction (STEMI) is a critical cardiovascular event.
- Multivessel coronary artery disease (MVD) is common in STEMI patients.
- Reperfusion therapy is standard for STEMI management.
Purpose of the Study:
- To assess the long-term impact of MVD on cause-specific mortality after STEMI.
- To determine if MVD is an independent predictor of mortality post-reperfusion therapy.
Main Methods:
- Study included 395 STEMI patients treated with reperfusion therapy.
- Follow-up duration was 8 years with cause-specific mortality assessment.
- Multivessel coronary artery disease (MVD) presence was determined for all patients.
Main Results:
- MVD was present in 57% of STEMI patients.
- MVD patients had lower ejection fraction and higher total mortality (32% vs 19%).
- MVD independently predicted heart failure deaths (HR 7.4) but not sudden death or total mortality.
Conclusions:
- STEMI patients with MVD face higher long-term mortality.
- MVD is a significant predictor of death from heart failure post-STEMI.
- MVD is not an independent predictor of overall mortality or sudden cardiac death.
Objectives:
To investigate the long-term impact of multivessel coronary artery disease (MVD) on cause-specific mortality in patients with ST elevation myocardial infarction (STEMI) treated with reperfusion therapy.
Methods And Results:
Patients with STEMI (n = 395) treated with primary angioplasty or thrombolysis in the setting of a randomised clinical trial were enrolled in the study. Follow up was 8 (2) years. For patients who died all available records were reviewed to assess the specific cause of death. MVD was present in 57% of patients. Patients with MVD were older and more of them had diabetes and previous myocardial infarction. Compared with the non-MVD group, residual left ventricular ejection fraction was lower (45.9% v 49.6%, p = 0.001) and total mortality was higher in patients with MVD (32% v 19%, p = 0.002). After adjustment for potential confounders this association was not significant (hazard ratio 1.4, 95% confidence interval (CI) 0.9 to 2.2). When the specific cause of death was considered, sudden death was comparable between patients with and without MVD (10% v 8%, p = 0.49) but death caused by heart failure was significantly higher in patients with MVD (hazard ratio 7.4, 95% CI 1.7 to 32.2).
Conclusion:
Patients with STEMI and MVD have a higher long-term mortality than do patients with non-MVD. MVD is not an independent predictor of long-term total mortality or sudden death. However, MVD is a very strong and independent predictor of long-term death caused by heart failure.
