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Ten-Year Outcomes Following Revascularization Strategies for Non-ST-Segment Elevation Myocardial Infarction and

Aykut Demirkıran1, Cihan Aydın1, Aydın Akyüz1

  • 1Department of Cardiology, Tekirdag Namık Kemal University, Tekirdağ, Turkiye.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|March 4, 2025
PubMed

Insights

Immediate or staged complete revascularization within 24 hours offers better long-term outcomes for non-ST-segment elevation myocardial infarction (NSTEMI) patients with multivessel disease (MVD). Staged procedures under 24 hours showed superior results compared to longer intervals.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Conflicting guidelines exist for revascularization in non-ST-segment elevation myocardial infarction (NSTEMI) with multivessel disease (MVD).
  • Optimal timing and strategy for revascularization remain debated.
  • Understanding long-term outcomes is crucial for patient management.

Purpose of the Study:

  • To compare long-term outcomes of immediate complete revascularization (ICR), staged complete revascularization (SCR), and non-complete revascularization (NCR) in NSTEMI patients with MVD.
  • To evaluate the impact of timing within SCR on outcomes.
  • To inform evidence-based treatment strategies.

Main Methods:

  • Retrospective analysis of 316 NSTEMI patients with MVD.
  • Categorization into ICR, SCR (≤24 hours and >24 hours), and NCR groups.
  • Assessment of cardiac composite outcomes (cardiac death, recurrent MI) during follow-up.

Main Results:

  • SCR demonstrated significantly lower risk compared to ICR (HR 0.27, P=0.001).
  • No significant difference was observed between NCR and SCR (HR 1.06, P=0.832).
  • Staged revascularization within 24 hours (SCR1) showed significantly lower adverse events than SCR >24 hours (16.7% vs. 47.1%, P=0.038).

Conclusions:

  • Immediate complete revascularization (ICR) and staged complete revascularization (SCR) within 24 hours are associated with favorable long-term outcomes.
  • Timely SCR (≤24 hours) is superior to delayed SCR (>24 hours) for NSTEMI patients with MVD.
  • These findings support prompt revascularization strategies for improved patient prognosis.
Abstract

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