A Small Sample Retrospective Study of Non-Infarct-Related Artery Simultaneous Revascularization during Primary Percutaneous Coronary Intervention for St-Segment Elevation Myocardial Infarction

Objective: In patients with acute myocardial infarction (AMI) and multivessel coronary disease undergoing primary percutaneous coronary intervention (PCI), we compare the major cardiovascular events and plasma inflammatory markers (hsCRP, sCD40L, IL-6, and TNF-a) after treatment with simultaneous complete revascularization or culprit-only primary angioplasty. Method: From June 2011 to June 2014, a total of 74 patients with AMI and multivessel coronary disease in our hospital underwent primary PCI, and among them 24 (32%) patients underwent simultaneous complete revascularization (complete PCI group) and 50 (68%) patients underwent culprit-only primary angioplasty (culpritonly group), then underwent PCI for the non-infarct-related artery at 1-4 weeks after primary PCI. The outcome was compared between the two groups one year after treatment. Result: There was no significant difference in the incidence of major adverse cardiovascular events (non-fatal myocardial infarction, target vessel repeat revascularization, and cardiac death) between the two groups at one year (P > 0.05). The changes of these inflammatory markers were not statistically significant between the two groups (P > 0.05). Conclusion: Compared to the culprit-only group, the complete PCI group had similar incidences of major adverse cardiovascular events (non-fatal myocardial infarction, target vessel repeat revascularization, all-cause and cardiac mortality). The present study suggests it was safe to intervene the non-infarct-related artery simultaneously during primary PCI. The elevated inflammatory marker levels were reduced in both groups, but the changes of these markers were not significantly different, so the long-term effects of these two PCI procedures are similar.