Impact of immediate multivessel intervention on outcome of patients with multivessel disease undergoing primary PCI for STEMI without cardiogenic shock for cardiogenic shock. Results of the prospective

Abstract

Background: There is still uncertainty about the optimal strategy in patients with multivessel disease undergoing primary PCI for STEMI. Therefore we compared outcome of patients with culprit lesion only PCI and immediate multivessel PCI for STEMI without cardiogenic shock in real life. Methods: We used the data of the prospective ALKK-PCI registry and included patients with primary PCI for STEMI without cardiogenic shock with 2-3 vessel disease. We excluded patients with left main PCI and patients with prior coronary artery bypass surgery. Treatment with multivessel PCI or culprit lesion only PCI was left on the discretion of the operator. Results: Between 2008 and 2011 a total of 5722 patients 2with -3 vessel disease were treated with primary PCI. Of these 539 (9%) received immediate multivessel PCI while in the remaining only the culprit vessel was treated. Baseline characteristics, procedural features and in-hospital outcomes are given in the table. View this table: Conclusion: Immediate multivessel PCI for STEMI without cardiogenic shock used in less than 10% of patients is associated with similar success rates as culprit lesion PCI, but with a higher mortality. Therefore a randomized trial seems warranted to evaluate the optimal interventional strategy in these patients.