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- Title
Complete and incomplete revascularization in non-ST segment myocardial infarction with multivessel disease: long-term outcomes of first- and second-generation drug-eluting stents.
- Authors
Hsieh, Ming-Jer; Chen, Chun-Chi; Lee, Cheng-Hung; Wang, Chao-Yung; Chang, Shang-Hung; Chen, Dong-Yi; Yang, Chia-Hung; Tsai, Ming-Lung; Yeh, Jih-Kai; Ho, Ming-Yun; Hsieh, I-Chang
- Abstract
The therapeutic effects of reperfusion strategies with complete revascularization (CR) or incomplete revascularization (IR) in non-ST segment myocardial infarction (NSTEMI) patients with multivessel disease (MVD) are controversial. In such patients, whether utilization of different generations of drug-eluting stents (DES) for IR or CR affect long-term major adverse cardiovascular events (MACE) is unknown. This study included 702 NSTEMI patients with MVD who received first-generation (1G) or second-generation (2G) DES. In multivariable analysis, chronic kidney disease, chronic total, 1G DES and IR were independent predictors of long-term MACE. In patients receiving 1G DES, no significant differences of MACE were observed between the IR and CR groups (39.1% vs. 36.2%, p = 0.854). However, in patients receiving 2G DES, significantly fewer MACE were observed in the CR group than in the IR group (3.7% vs. 10.2%, p = 0.002). Compared with patients receiving 1G DES for IR, those receiving 2G DES for IR and CR exhibited significantly lower risk of MACE (59% and 83% lower, respectively). CR could not provide clinical benefits over IR in NSTEMI patients with MVD receiving 1G DES. However, in patients receiving 2G DES, compared with IR, CR was associated with a lower risk of long-term MACE, which was mainly caused by low rates of non-TLR and any revascularization.
- Subjects
MYOCARDIAL infarction; KIDNEY diseases
- Publication
Heart & Vessels, 2019, Vol 34, Issue 2, p251
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-018-1252-z