医学
狼牙棒
内科学
心脏病学
心肌梗塞
经皮冠状动脉介入治疗
危险系数
血运重建
冠状动脉疾病
罪魁祸首
置信区间
作者
Min Chul Kim,Ju Yong Hyun,Youngkeun Ahn,SungA Bae,Dae Young Hyun,Kyung Hoon Cho,Doo Sun Sim,Young Joon Hong,Ju Han Kim,Myung Ho Jeong,Hyo Soo Kim,Hyeon Cheol Gwon,In Whan Seong,Kyoung Kook Hwang,Shung Chull Chae,Seung Ho Hur,Kwang Soo,Seok Kyu Oh
标识
DOI:10.1161/jaha.120.016575
摘要
Background Few studies have investigated optimal revascularization strategies in non–ST‐segment–elevation myocardial infarction with multivessel disease. We investigated 3‐year clinical outcomes according to revascularization strategy in patients with non–ST‐segment–elevation myocardial infarction and multivessel disease. Methods and Results This retrospective, observational, multicenter study included patients with non–ST‐segment–elevation myocardial infarction and multivessel disease without cardiogenic shock. Data were analyzed at 3 years according to the percutaneous coronary intervention strategy: culprit‐only revascularization (COR), 1‐stage multivessel revascularization (MVR), and multistage MVR. The primary outcome was major adverse cardiac events (MACE: a composite of all‐cause death, nonfatal spontaneous myocardial infarction, or any repeat revascularization). The COR group had a higher risk of MACE than those involving other strategies (COR versus 1‐stage MVR; hazard ratio, 0.65; 95% CI, 0.54–0.77; P <0.001; and COR versus multistage MVR; hazard ratio, 0.74; 95% CI, 0.57–0.97; P =0.027). There was no significant difference in the incidence of MACE between 1‐stage and multistage MVR (hazard ratio, 1.14; 95% CI, 0.86–1.51; P =0.355). The results were consistent after multivariate regression, propensity score matching, inverse probability weighting, and Bayesian proportional hazards modeling. In subgroup analyses stratified by the Global Registry of Acute Coronary Events score, 1‐stage MVR lowered the risk of MACE compared with multistage MVR in low‐to‐intermediate risk patients but not in patients at high risk. Conclusions MVR reduced 3‐year MACE in patients with non–ST‐segment–elevation myocardial infarction and multivessel disease compared with COR. However, 1‐stage MVR was not superior to multistage MVR for reducing MACE except in low‐to‐intermediate risk patients.
科研通智能强力驱动
Strongly Powered by AbleSci AI