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Multivessel Disease As A Prognostic Marker In Patients Presenting For Primary Percutaneous Coronary Intervention
Mahesh Kumar Batra1, Syed Ishtiaq Rasool1, Bashir Ahmed Solangi1
1Cardiology Department, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Insights
Multi-vessel disease in ST-Elevation Myocardial Infarction (STEMI) patients undergoing primary PCI leads to worse outcomes, including higher mortality and complications. This highlights the critical impact of multi-vessel disease on patient prognosis and hospital stay.
Area of Science:
- Cardiology
- Interventional Cardiology
- Acute Coronary Syndromes
Background:
- Multi-vessel disease (MVD) is linked to increased mortality in ST-Elevation Myocardial Infarction (STEMI) patients.
- MVD can significantly influence clinical course and treatment decisions in STEMI.
- Primary Percutaneous Coronary Intervention (PCI) is a key treatment for STEMI.
Purpose of the Study:
- To determine the prevalence of MVD in STEMI patients undergoing primary PCI.
- To compare in-hospital and early post-discharge outcomes (up to 30 days) between STEMI patients with MVD and single-vessel disease (SVD).
Main Methods:
- A study of 282 consecutive STEMI patients undergoing primary PCI at NICVD, Karachi.
- Assessment and comparison of demographic data, clinical history, procedural complications, and short-term adverse events between SVD and MVD groups.
- Statistical analysis using z-test, t-test, and Fisher's Exact test.
Main Results:
- Patients with MVD experienced worse post-procedural outcomes compared to SVD patients.
- MVD was associated with increased overall complications, longer hospital stays, and higher in-hospital mortality.
- Higher referral rates for Coronary Artery Bypass Grafting (CABG) were observed in the MVD group.
- A trend towards higher symptom recurrence and re-admission was noted in MVD patients, though not statistically significant.
Conclusions:
- MVD in STEMI patients undergoing primary PCI is a direct indicator of significantly higher post-procedure complications, mortality, and morbidity.
- Prolonged hospitalization is a key consequence of MVD in this patient population.
- The risk of symptom recurrence and re-admission remains elevated for STEMI patients with MVD.
Background:
Multi-vessel disease is associated with higher mortality rates in ST-Elevation Myocardial Infarction (STEMI) patients, which may further alter clinical course and decision making. Hence, the purpose of this study is to determine prevalence, in hospital and early after discharge (up to 30 days) outcome of patients with multi-vessel disease as compared to single vessel disease presenting with acute STEMI undergoing Primary PCI.
Methods:
This study includes 282 consecutive selected patients, presented in emergency department with acute STEMI; undergo primary percutaneous coronary intervention (PCI) at Catheterization Laboratory of National Institute of Cardiovascular Diseases (NICVD), Karachi Pakistan during the study period of 17th December 2016 to 16th June 2017. Demographic characteristics, clinical history, post procedural complications, and short term adverse clinical events in patients with SVD and MVD were assessed and compared using z-test, t-test, and Fisher's Exact test..
Results:
Comparing the patients with single vessel disease, multi-vessel disease patients have worse post procedural outcomes, increased overall complications, length of hospital stay, higher referral for CABG, and in-hospital mortality. On follow up relatively higher, but not statistically significant, patient with MVD developed recurrence of symptoms and got re-admission.
Conclusions:
Multi-vessel disease in patients presenting for primary PCI is the direct indicative of significantly higher post procedure complications, mortality, morbidity, and prolonged hospitalization. Also, risk of recurrence of symptoms and re-admission remains high in patients with multi-vessel disease..
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