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Complete or incomplete coronary revascularisation in patients with myocardial infarction and multivessel disease: a propensity score analysis from the "real-life" BleeMACS (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome) registry

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机构: [1]Dipartimento Sci Med, Div Cardiologia Citta Salute & Sci, Turin, Italy; [2]Univ Hosp Alvaro Cunqueiro, Vigo, Spain; [3]Univ Acad Med Ctr, Amsterdam, Netherlands; [4]NorthShore Univ Hosp, Chicago, IL USA; [5]Univ Clin Hosp Santiago De Compostela, Santiago De Compostela, Spain; [6]Libin Cardiovasc Inst Alberta, Calgary, AB, Canada; [7]San Carlos Hosp, Madrid, Spain; [8]Bellvitge Hosp, Barcelona, Spain; [9]Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China; [10]Univ Patras Hosp, Athens, Greece; [11]Kerckhoff Heart & Thorax Ctr, Frankfurt, Germany; [12]Univ Clin Hosp, Kyoto, Japan; [13]Univ Clin Hosp, Warsaw, Poland; [14]Inst Heart Lung arid Blood Vessel Dis, Beijing, Peoples R China; [15]Tokai Univ, Sch Med, Tokyo, Japan; [16]Hosp Sao Rafael; [17], Salvador, BA, Brazil; [18]Kanazawa Univ, Grad Sch Med, Div Cardiovasc Med, Kanazawa, Ishikawa, Japan; [19]Univ Clin Cardiol, Skopje, Macedonia; [20]Infenni Hospital; [21], Div Cardiol, Turin, Italy; [22]Univ Turin, Dept Med Sci, Div Cardiol, Citta Salute & Sci, I-10126 Turin, Italy
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关键词: multiple vessel disease non-ST-segment elevation myocardial infarction (NSTEMI) ST-segmentelevation myocardial infarction (STEMI)

摘要:
Aims: The benefit of complete or incomplete percutaneous coronary Intervention (PC in patients with myocardial infarction and multivessel disease remains debated. The aim of our study was to compare a complete vs. a "culprit only" revascularisation strategy hi patients with myocardial infarction distinguishing the different clinical subsets (STEM and NSTEMI) and to provide one-year clinical outcome from the "real-life" BleeMACS (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome) registry. Methods and results: We conducted a multicentre study including all patients with myocardial infarction and multivessel coronary disease included in the BleeMACS (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronae Syndrome) registry. They were divided into two groups, complete revascularisation (CR) and incomplete revascularisation (IR). The primary end-point was the death rate at one-year follow-up. Secondary end-points were in-hospital repeat myocardial infarction (re-AM1), in-hospital heart failure (111:), major adverse cardiovascular events (MACE) and myocardial infarction at one year. Four thousand five hundred and twenty patients were included in our analysis, with a diagnosis of STEMI in 67.7% and NSTEMI in 32.3%. CR was performed in 27.2% and 42.4%, respectively. At univariate analysis, in-hospital and one-year outcomes were similar between CR and IR hi STEMI patients (all p-values >0.05). In NSTEMI patients, CR was associated with a lower one-year death rate (4.5% vs. 8.5%; 1)p=0.002), re-AMI (3.7% vs. 6.6%; p=0.016) and MACE (8.1% vs. 13.9%; p=0.001). After propensity score matching, CR also reduced events in STEM patients, including one-vear mortality (5.3% vs. 13.8%; p<0.001), re-AMI (4.9% vs. 17.4%; p<0.001) and MACE (8.5% vs. 24.6%; p<0.001.). Conclusions: This tulticentre retrospective registry showed the benefit of CR 1 terms of reduction of one-year mortality in patients with myocardial reinfarction and multivessel coronary disease. Randomised controlled trials including functional evaluation of the lesions should be performed to confirm our results.

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出版当年[2016]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 心脏和心血管系统
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出版当年[2015]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

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第一作者机构: [1]Dipartimento Sci Med, Div Cardiologia Citta Salute & Sci, Turin, Italy;
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通讯机构: [1]Dipartimento Sci Med, Div Cardiologia Citta Salute & Sci, Turin, Italy; [22]Univ Turin, Dept Med Sci, Div Cardiol, Citta Salute & Sci, I-10126 Turin, Italy
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