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

Abstract 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...

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Published in:European heart journal 2022-10, Vol.43 (Supplement_2)
Main Authors: Hlinomaz, O, Motovska, Z, Kala, P, Hromadka, M, Precek, J, Mrozek, J, Cervinka, P, Kettner, J, Matejka, J, Zohor, A, Bis, J, Jarkovsky, J
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Language:English
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Summary:Abstract 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
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehac544.2069