Prognostic impact of direct percutaneous coronary intervention on non-infarction related artery simultaneously on ST-segment elevation myocardial infarction in patients with multivessel disease

Objective To investigate the prognosis of direct percutaneous coronary intervention(PCI)on infarction related artery(IRA)and simultaneously on non-infarct related artery(non-IRA)on ST-segment elevation myocardial infarction(STEMI)patients with multivessel disease. Methods The178 patients with STEMI multivessel disease were enrolled into this study in Department of Cardiology, XiJing Hospital of Fourth Military University, from Janurary of 2015 to June of 2016.All patients were divided into multivessel primary PCI group(42 cases)and staged PCI group(136 cases)based on the interventional timing of non-IRA.The data of PCI and the complications during hospitalization were compared between the two groups.Patients were followed up for one year, and the levels of left ventricular ejection fraction(LVEF)and the rates of major adverse cardiovascular events(MACE)were compared between the two groups. Results Compared with the staged PCI group, the hospitalization time [(5.5±1.5)d vs.(9.5±1.5)d, t=3.97, P=0.02] and hospitalization cost [RMB: (46 765±20 242)yuan vs.(54 884±22 885)yuan, t=3.88, P=0.04] were significantly lower in the primary PCI group; however, the perioperative complications increased in primary PCI group, while without statistically difference [6 cases(14.3%)vs.13 cases(9.6%), χ2=0.61, P=0.40]. Meanwhile, incidence of MACE had no significant difference between two groups in one year after PCI [10 cases(23.8%)vs.24 cases(17.6%), χ2=0.79, P=0.38]. LVEF in primary PCI group was significant higher compared with staged PCI group(59.7%±3.4% vs.55.0%±4.1%, t=3.87, P=0.04). Conclusions Direct PCI on non-IRA simultaneously on STEMI patients with multivessel disease may reduce hospitalization time and hospitalization expenses, reduce contrast dose, improve LVEF without increase of complications and incident of MACE.Therefore, it could be used as a strategy for STEMI patients by direct PCI if the estimated successful rate is high enough. Key words: Myocardial infarction; Non infarct related artery; Angioplasty, transluminal, percutaneous coronary