All-cause mortality of patients with STEMI, cardiogenic shock
and multivessel coronary disease treated with culprit vessel
only versus multivessel primary PCI

a 2022

All-cause mortality of patients with STEMI, cardiogenic shock and multivessel coronary disease treated with culprit vessel only versus multivessel primary PCI

HLINOMAZ, Ota, Z. MOTOVSKA, Petr KALA, M. HROMADKA, J. PRECEK et. al.

Základní údaje

Originální název

All-cause mortality of patients with STEMI, cardiogenic shock and multivessel coronary disease treated with culprit vessel only versus multivessel primary PCI

Autoři

HLINOMAZ, Ota (203 Česká republika, garant, domácí), Z. MOTOVSKA (203 Česká republika), Petr KALA (203 Česká republika, domácí), M. HROMADKA (203 Česká republika), J. PRECEK (203 Česká republika), J. MROZEK (203 Česká republika), P. CERVINKA (203 Česká republika), J. KETTNER (203 Česká republika), J. MATEJKA (203 Česká republika), A. ZOHOR (203 Česká republika), J. BIS (203 Česká republika) a Jiří JARKOVSKÝ (203 Česká republika, domácí)

Vydání

ESC Congress 2022 - Barcelona, Spain, 26-29 August 2022, 2022

Další údaje

Jazyk

angličtina

Typ výsledku

Konferenční abstrakt

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 39.300

Kód RIV

RIV/00216224:14110/22:00129746

Organizační jednotka

Lékařská fakulta

ISSN

UT WoS

000894947901282

Klíčová slova anglicky

STEMI; cardiogenic shock; multivessel coronary disease; mortality; culprit vessel; multivessel primary PCI

Štítky

rivok

Příznaky

Mezinárodní význam

Změněno: 24. 4. 2023 15:25, Mgr. Tereza Miškechová

Anotace

V originále

Background Patients with ST elevation myocardial infarction (STEMI) and cardiogenic shock (CS) treated with primary percutaneous coronary intervention (pPCI) have high mortality. A recent trial demonstrated that a culprit vessel-only strategy (CV-pPCI) was superior to immediate multivessel PCI (MV-pPCI) for patients with CS and multivessel coronary artery disease (MVD). Irrespective of it and current guidelines, multivessel PCI is still often used in these patients. Purpose/Methods The study aimed to compare the characteristics and prognosis of patients with CS-STEMI and MVD treated with culprit vessel only pPCI or multivessel PCI during initial procedure. From 2016 to 2020, 23703 primary PCI patients with STEMI were included in the national all-comers registry of cardiovascular interventions. From them, a total of 1213 (5.1%) patients had cardiogenic shock and MVD at admission to the hospital. Initially 921 (75.9%) patients were treated with CV-pPCI and 292 (24.1%) with MV-pPCI. Results CV-pPCI was a preferred strategy to MV-pPCI in men (74.6% vs 25.4%; p<0,001) and women (79.8% vs 20.2%; p<0,001) with CS-STEMI and MVD. Patients with 3-vessel disease and left main disease had higher probability to be treated with MV-pPCI than patients with 2-vessel disease and without left main disease (28.5% vs 18.6%; p<0,001 and 37.7% vs 20.6%; p<0,001).The CV-pPCI and MV-pPCI group patients did not differ in age (68.1±11.2 vs 66.2±11.4 years; p=0.780), previous PCI (16.1% vs 12.0%; p=0.890) and CABG (6.2% vs 4.8%; p=0.376), chronic kidney disease (6.8% vs 8.2%; p=0.426), cardiopulmonary resuscitation (60.4% vs 58.9%; p=0.657) and pulmonary ventilation (66.8% vs 70.5%; p=0.227) at admission, localization of myocardial infarction (anterior 50.8.% vs 58.9%; p=0.671), time to reperfusion (<2 hours 5.2% vs 4.8%; p=0.722) and TIMI flow 0 before PCI (63.1% vs 64.0%; p=0.675). Based on the results of logistic regression analysis, 30-days (odds ratio, 0.99; 95% CI 0.76 to 1.29; p=0.937) and 1-year (odds ratio, 0.91; 95% CI 0.69 to 1.19; p=0.477) all-cause mortality rates were similar in CV-pPCI and MV-pPCI groups. The presence of 3-vessel disease was the strongest adjusted predictor of 30-days (odds ratio, 1.61; 95% CI 1.27 to 2.04; p<0.001) and 1-year (odds ratio, 1.64; 95% CI 1.30 to 2.08; p<0.001) all-cause mortality in patients with STEMI and CS treated with pPCI. Conclusion Immediate multivessel primary PCI is still used in patients with CS-STEMI and MVD in routine clinical practice. We did not find difference in 30-days and 1-year mortality among patients with CS-STEMI and MVD treated either with culprit vessel-only or multivessel primary PCI.

Návaznosti

NV19-02-00086, projekt VaV

Název: Duální protidestičková léčba pacientů s akutním infarktem myokardu v kardiogenním šoku - studie DAPT-SHOCK AMI

Investor: Ministerstvo zdravotnictví ČR, Duální protidestičková léčba pacientů s akutním infarktem myokardu v kardiogenním šoku - studie DAPT-SHOCK AMI

Citovat

HLINOMAZ, Ota, Z. MOTOVSKA, Petr KALA, M. HROMADKA, J. PRECEK, J. MROZEK, P. CERVINKA, J. KETTNER, J. MATEJKA, A. ZOHOR, J. BIS a Jiří JARKOVSKÝ. All-cause mortality of patients with STEMI, cardiogenic shock and multivessel coronary disease treated with culprit vessel only versus multivessel primary PCI. In ESC Congress 2022 - Barcelona, Spain, 26-29 August 2022. 2022. ISSN 0195-668X.

@proceedings{2277417,
   author = {Hlinomaz, Ota and Motovska, Z. and Kala, Petr and Hromadka, M. and Precek, J. and Mrozek, J. and Cervinka, P. and Kettner, J. and Matejka, J. and Zohor, A. and Bis, J. and Jarkovský, Jiří},
   booktitle = {ESC Congress 2022 - Barcelona, Spain, 26-29 August 2022},
   keywords = {STEMI; cardiogenic shock; multivessel coronary disease; mortality; culprit vessel; multivessel primary PCI},
   language = {eng},
   title = {All-cause mortality of patients with STEMI, cardiogenic shock and multivessel coronary disease treated with culprit vessel only versus multivessel primary PCI},
   url = {https://academic.oup.com/eurheartj/article/43/Supplement_2/ehac544.2069/6745787},
   year = {2022}
}

TY  - CONF
ID  - 2277417
AU  - Hlinomaz, Ota - Motovska, Z. - Kala, Petr - Hromadka, M. - Precek, J. - Mrozek, J. - Cervinka, P. - Kettner, J. - Matejka, J. - Zohor, A. - Bis, J. - Jarkovský, Jiří
PY  - 2022
TI  - All-cause mortality of patients with STEMI, cardiogenic shock and multivessel coronary disease treated with culprit vessel only versus multivessel primary PCI
KW  - STEMI
KW  - cardiogenic shock
KW  - multivessel coronary disease
KW  - mortality
KW  - culprit vessel
KW  - multivessel primary PCI
UR  - https://academic.oup.com/eurheartj/article/43/Supplement_2/ehac544.2069/6745787
N2  - Background Patients with ST elevation myocardial infarction (STEMI) and cardiogenic shock (CS) treated with primary percutaneous coronary intervention (pPCI) have high mortality. A recent trial demonstrated that a culprit vessel-only strategy (CV-pPCI) was superior to immediate multivessel PCI (MV-pPCI) for patients with CS and multivessel coronary artery disease (MVD). Irrespective of it and current guidelines, multivessel PCI is still often used in these patients. Purpose/Methods The study aimed to compare the characteristics and prognosis of patients with CS-STEMI and MVD treated with culprit vessel only pPCI or multivessel PCI during initial procedure. From 2016 to 2020, 23703 primary PCI patients with STEMI were included in the national all-comers registry of cardiovascular interventions. From them, a total of 1213 (5.1%) patients had cardiogenic shock and MVD at admission to the hospital. Initially 921 (75.9%) patients were treated with CV-pPCI and 292 (24.1%) with MV-pPCI. Results CV-pPCI was a preferred strategy to MV-pPCI in men (74.6% vs 25.4%; p<0,001) and women (79.8% vs 20.2%; p<0,001) with CS-STEMI and MVD. Patients with 3-vessel disease and left main disease had higher probability to be treated with MV-pPCI than patients with 2-vessel disease and without left main disease (28.5% vs 18.6%; p<0,001 and 37.7% vs 20.6%; p<0,001).The CV-pPCI and MV-pPCI group patients did not differ in age (68.1±11.2 vs 66.2±11.4 years; p=0.780), previous PCI (16.1% vs 12.0%; p=0.890) and CABG (6.2% vs 4.8%; p=0.376), chronic kidney disease (6.8% vs 8.2%; p=0.426), cardiopulmonary resuscitation (60.4% vs 58.9%; p=0.657) and pulmonary ventilation (66.8% vs 70.5%; p=0.227) at admission, localization of myocardial infarction (anterior 50.8.% vs 58.9%; p=0.671), time to reperfusion (<2 hours 5.2% vs 4.8%; p=0.722) and TIMI flow 0 before PCI (63.1% vs 64.0%; p=0.675). Based on the results of logistic regression analysis, 30-days (odds ratio, 0.99; 95% CI 0.76 to 1.29; p=0.937) and 1-year (odds ratio, 0.91; 95% CI 0.69 to 1.19; p=0.477) all-cause mortality rates were similar in CV-pPCI and MV-pPCI groups. The presence of 3-vessel disease was the strongest adjusted predictor of 30-days (odds ratio, 1.61; 95% CI 1.27 to 2.04; p<0.001) and 1-year (odds ratio, 1.64; 95% CI 1.30 to 2.08; p<0.001) all-cause mortality in patients with STEMI and CS treated with pPCI. Conclusion Immediate multivessel primary PCI is still used in patients with CS-STEMI and MVD in routine clinical practice. We did not find difference in 30-days and 1-year mortality among patients with CS-STEMI and MVD treated either with culprit vessel-only or multivessel primary PCI.
ER  -

HLINOMAZ, Ota, Z. MOTOVSKA, Petr KALA, M. HROMADKA, J. PRECEK, J. MROZEK, P. CERVINKA, J. KETTNER, J. MATEJKA, A. ZOHOR, J. BIS a Jiří JARKOVSKÝ. All-cause mortality of patients with STEMI, cardiogenic shock and multivessel coronary disease treated with culprit vessel only versus multivessel primary PCI. In \textit{ESC Congress 2022 - Barcelona, Spain, 26-29 August 2022}. 2022. ISSN~0195-668X.

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