Related Experiment Video

Updated: Jan 5, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

9.6K

The effect of complete revascularization in patients with ST-segment elevation myocardial infarction with Killip

Wei-Chieh Lee1,2, Tien-Yu Chen1, Chien-Jen Chen1

  • 1Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung.

Coronary Artery Disease
|October 29, 2019
PubMed

Insights

Complete revascularization (CR) in high-risk ST-segment elevation myocardial infarction (STEMI) patients with Killip class III or higher did not improve outcomes and may increase acute kidney injury risk. Staged CR showed better results than immediate CR.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Myocardial Infarction Research

Background:

  • Complete revascularization (CR) in ST-segment elevation myocardial infarction (STEMI) patients, particularly those critically ill (Killip class ≥ III), remains controversial.
  • Assessing the impact of CR on high-risk STEMI patients with cardiogenic shock is crucial for treatment strategies.

Purpose of the Study:

  • To evaluate the effect of complete revascularization (CR) versus culprit-only percutaneous coronary intervention (PCI) on clinical outcomes in STEMI patients with Killip class ≥ III.
  • To compare immediate versus staged CR strategies within the same hospitalization.

Main Methods:

  • A retrospective study of 185 STEMI patients (Killip class ≥ III) from 2008-2014 who underwent primary PCI.
  • Patients were divided into culprit-only PCI (89) and CR groups (96), with CR further divided into immediate (51) and staged (45).
  • Thirty-day and 1-year clinical outcomes, including mortality and acute kidney injury, were compared.

Main Results:

  • A trend towards lower post-PCI acute kidney injury was observed in the culprit-only PCI group (14.8%) compared to the CR group (26.0%; P=0.069).
  • No significant differences in 30-day or 1-year cardiovascular or all-cause mortality were found between culprit-only PCI and CR groups.
  • The staged CR group demonstrated decreased 1-year cardiovascular and all-cause mortality compared to the immediate CR group.

Conclusions:

  • Complete revascularization in high-risk STEMI patients (Killip class ≥ III) did not improve clinical outcomes and was associated with a higher risk of post-PCI acute kidney injury.
  • Staged CR during the same hospitalization was associated with better clinical outcomes than immediate CR.
Abstract

More Related Videos

Myocardial Infarction and Functional Outcome Assessment in Pigs12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

28.5K
Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

4.2K

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
675
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
191
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
144
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
199
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
210
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
286