Related Experiment Video
Updated: Sep 19, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Coronary revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease:
Aleksandra Kwapiszewska-Szybalska1, Łukasz Zandecki2, Marcin Sadowski2
1Collegium Medicum, Jan Kochanowski University, Kielce, Poland. ola.kwapiszewska@gmail.com
Insights
Long-term survival is similar for ST-segment elevation myocardial infarction patients with 2-vessel or 3-vessel disease. Potent antiplatelets and non-infarct artery revascularization may reduce readmissions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Research
Background:
- Multivessel coronary artery disease (MVD) affects one-third of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI).
- Long-term prognosis and readmission rates in STEMI patients with MVD are not well-established.
- This study addresses the prognostic uncertainty in this high-risk patient cohort.
Purpose of the Study:
- To evaluate the long-term risk of cardiovascular events and hospital readmissions in STEMI patients with MVD.
- To compare outcomes between patients with 2-vessel disease (2-VD) and 3-vessel disease (3-VD).
Main Methods:
- Prospective observational study of 1513 patients from the Silesian Cardiovascular Database (2017-2020).
- Analysis of demographic, clinical, and angiographic data.
- Two-year follow-up to assess prognosis and readmission rates.
Main Results:
- 439 MVD patients identified: 329 with 2-VD (74.9%) and 110 with 3-VD (25.1%).
- Similar overall survival and major adverse cardiovascular events (death, MI, stroke) at 2 years between 2-VD and 3-VD groups.
- Previous MI and left main IRA increased unplanned cardiac readmissions. Clopidogrel use increased all-cause readmissions.
- PCI of a non-IRA during index hospitalization reduced both unplanned cardiac and all-cause readmissions.
Conclusions:
- Two-year survival and event-free survival are comparable for STEMI patients with 2-VD versus 3-VD.
- Utilizing more potent antiplatelet agents over clopidogrel may lower readmission rates.
- Revascularization of non-infarct-related arteries during initial hospitalization is associated with reduced readmission risk.
Introduction:
Multivessel coronary artery disease (MVD) occurs in one‑third of patients with ST‑segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (pPCI). However, long‑term prognosis and readmission rates in this high‑risk group remain unclear.
Objectives:
We aimed to evaluate the long‑term risk of cardiovascular events and readmissions in STEMI patients with MVD.
Patients And Methods:
This prospective observational study included 1513 patients enrolled in the Silesian Cardiovascular Database between 2017 and 2020. We analyzed demographic, clinical, and angiographic characteristics along with prognosis during 2‑year follow‑up.
Results:
A total of 439 patients with MVD were identified in the registry. Among them, 2‑vessel disease (2‑VD) was detected in 329 patients (74.9%) and 3‑vessel disease (3‑VD) in 110 (25.1%). During 2‑year follow‑up, overall survival and the incidence of major adverse cardiovascular events (death, MI, stroke) were similar in both groups. In multivariable analyses, previous MI (hazard ratio [HR], 1.63; 95% CI, 1.01-2.63; P = 0.04) and the left main coronary artery as the infarct‑related artery (IRA; HR, 3.22; 95% CI, 1-10.38; P = 0.049) increased the risk of unplanned cardiac readmissions, whereas clopidogrel use (HR, 1.45; 95% CI, 1.07-1.95; P = 0.01) increased the risk of all‑cause readmissions. PCI of a non‑IRA during the index hospitalization was associated with a lower risk of both unplanned cardiac (HR, 0.61; 95% CI, 0.42-0.9; P = 0.01) and all‑cause (HR, 0.61; 95% CI, 0.46-0.82; P = 0.001) readmissions.
Conclusions:
Two‑year overall survival and event‑free survival were similar in STEMI patients with 2‑VD and 3‑VD. The use of more potent antiplatelets instead of clopidogrel as well as non‑IRA revascularization during the index hospitalization appear to be important for minimizing readmission rates.
More Related Videos
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Coronary Artery Disease IV: Preventive Measures
01:26Coronary Artery Disease II: Pathophysiology
01:30Coronary Artery Disease I: Introduction
01:30Coronary Artery Disease III: Clinical Manifestations