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Revascularization strategies in STEMI and multivessel disease
Inês Almeida1, Joana Chin1, Hélder Santos1
1Cardiology Departement, Barreiro-Montijo Hospital Center, Portugal.
Acta Cardiologica
|December 8, 2021
Summary
Complete revascularization (CR) in ST-elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) significantly reduces mortality and major adverse cardiovascular events (MACE). This strategy is particularly beneficial for hemodynamically stable individuals.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Research
Background:
- ST-elevation myocardial infarction (STEMI) treatment aims to restore coronary blood flow.
- Multivessel disease (MVD) complicates STEMI, increasing mortality.
- Complete revascularization (CR) is recommended to reduce major adverse cardiovascular events (MACE).
Purpose of the Study:
- To evaluate the revascularization strategy and its prognostic impact in Portuguese STEMI patients with MVD.
- To compare outcomes between complete and incomplete revascularization in this cohort.
Main Methods:
- Retrospective analysis of 3500 STEMI patients from the Portuguese Registry of Acute Coronary Syndromes (2010-2019).
- Patients categorized by revascularization strategy: complete vs. incomplete.
- Multivariate logistic regression identified predictors of mortality and cardiovascular rehospitalization.
Main Results:
- CR was performed in 21.8% of patients, who were generally younger, healthier, and more hemodynamically stable.
- CR patients had less complex coronary anatomy and fewer chronic occlusions.
- In-hospital and 1-year adverse events were lower in the CR group.
Conclusions:
- Complete revascularization significantly reduces in-hospital and 1-year all-cause mortality and MACE in hemodynamically stable STEMI patients with MVD.
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