Clinical Outcomes of Complete Revascularization in Acute Myocardial Infarction Patients With High Bleeding Risk and...

Area of Science:

• Cardiology
• Interventional Cardiology
• Clinical Research

Background:

• High bleeding risk (HBR) in acute myocardial infarction (AMI) patients correlates with worse prognosis.
• Limited data exists on the impact of complete revascularization (CR) in AMI patients with multivessel disease and HBR.

Purpose of the Study:

• To evaluate the prognostic impact of CR in AMI patients with multivessel disease, specifically comparing outcomes between those with and without HBR.
• To assess the association of CR with major adverse cardiac and cerebrovascular events (MACCE) and bleeding events in these patient groups.

Main Methods:

• Analysis of 13,460 patients with AMI and multivessel disease from a Korean registry (2011-2020).
• Patients underwent successful percutaneous coronary intervention for the infarct-related artery.
• Primary outcome was MACCE over 3-year follow-up; HBR classification used modified Academic Research Consortium-HBR criteria.

Main Results:

• 32.7% of patients had HBR; 35.8% underwent CR.
• HBR patients had significantly higher MACCE (35.7% vs. 16.4%) and bleeding risk (10.4% vs. 4.5%) compared to non-HBR.
• CR was associated with lower MACCE in both HBR (28.1% vs. 40.0%) and non-HBR (13.1% vs. 19.0%) groups, with similar bleeding event rates between CR and incomplete revascularization.

Conclusions:

• CR improves outcomes by reducing MACCE in AMI patients with multivessel disease, irrespective of bleeding risk.
• CR is a safe and effective strategy for both HBR and non-HBR patients, demonstrating comparable bleeding event rates.