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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

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Multivessel vs. culprit vessel-only percutaneous coronary intervention in ST-segment elevation myocardial infarction

Jing Wu1, Yonggang Wang2, Chenguang Li3

  • 1Department of Translational Medicine, The First Hospital of Jilin University, Changchun, China.

Frontiers in Cardiovascular Medicine
|December 12, 2022
PubMed

Insights

Multivessel percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is declining. While safe for STEMI without cardiogenic shock, it increases mortality for STEMI with cardiogenic shock.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • Early revascularization is key for ST-elevation myocardial infarction (STEMI) mortality reduction.
  • The impact of multivessel percutaneous coronary intervention (PCI) on STEMI outcomes, especially with cardiogenic shock, requires updated analysis.

Purpose of the Study:

  • To investigate recent trends in multivessel PCI for STEMI patients.
  • To evaluate the in-hospital outcomes associated with multivessel PCI in STEMI patients, stratified by the presence or absence of cardiogenic shock.

Main Methods:

  • Analysis of the National Inpatient Sample database (October 2015-2019).
  • Comparison of in-hospital outcomes (mortality, MACCE) between multivessel PCI and culprit-only PCI in STEMI patients.
  • Stratification of analysis based on cardiogenic shock presence.

Main Results:

  • Multivessel PCI use declined from 20.8% (2015) to 13.9% (2019) for STEMI without cardiogenic shock.
  • For STEMI without cardiogenic shock, multivessel PCI showed similar in-hospital mortality (2.4% vs 2.3%) and MACCE (7.4% vs 7.2%) compared to culprit-only PCI.
  • For STEMI with cardiogenic shock, multivessel PCI use declined from 29.2% (2015) to 19.4% (2019) and was associated with higher mortality (30.9% vs 28.4%) and MACCE (39.9% vs 36.5%).

Conclusions:

  • The utilization of multivessel PCI for STEMI is decreasing.
  • Multivessel PCI is linked to poorer in-hospital outcomes in STEMI patients experiencing cardiogenic shock.
  • Multivessel PCI does not appear to worsen in-hospital outcomes for STEMI patients without cardiogenic shock.
Abstract

Keywords:
National Inpatient Database (NIS)STEMIcardiogenic shockculprit-only PCImultivessel PCI

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