In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 10 ( 2021-10-13), p. e0258525-
Abstract:
A substantial number of patients presenting with non-ST-elevation myocardial infarction (NSTEMI) and multivessel disease (MVD) have severe left ventricular systolic dysfunction (LVSD) (left ventricular ejection fraction (LVEF) less than 35%). But data are lacking regarding optimal percutaneous coronary intervention (PCI) strategy for these patients. The aim of this study was to compare the long-term outcomes of IRA (infarct-related artery)-only and multivessel PCI in patients with NSTEMI and MVD complicated by severe LVSD. Methods Among 13,104 patients enrolled in the PCI registry from November 2011 to December 2015, patients with NSTEMI and MVD with severe LVSD who underwent successful PCI were screened. The primary outcome was 3-year major adverse cardiovascular events (MACEs), defined as all-cause death, any myocardial infarction, stroke, and any revascularization. Results Overall, 228 patients were treated with IRA-only PCI (n = 104) or MV-PCI (n = 124). The MACE risk was significantly lower in the MV-PCI group than in the IRA-only PCI group (35.5% vs. 54.8%; hazard ratio [HR] 0.561; 95% confidence interval [CI] 0.378–0.832; p = 0.04). This result was mainly driven by a significantly lower risk of all-cause death (23.4% vs. 41.4%; hazard ratio [HR] 0.503; 95% confidence interval [CI] 0.314–0.806; p = 0.004). The results were consistent after multivariate regression, propensity-score matching, and inverse probability weighting to adjust for baseline differences. Conclusions Among patients with NSTEMI and MVD complicated with severe LVSD, multivessel PCI was associated with a significantly lower MACE risk. The findings may provide valuable information to physicians who are involved in decision-making for these patients.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0258525
DOI:
10.1371/journal.pone.0258525.g001
DOI:
10.1371/journal.pone.0258525.g002
DOI:
10.1371/journal.pone.0258525.g003
DOI:
10.1371/journal.pone.0258525.g004
DOI:
10.1371/journal.pone.0258525.t001
DOI:
10.1371/journal.pone.0258525.t002
DOI:
10.1371/journal.pone.0258525.t003
DOI:
10.1371/journal.pone.0258525.t004
DOI:
10.1371/journal.pone.0258525.s001
DOI:
10.1371/journal.pone.0258525.s002
DOI:
10.1371/journal.pone.0258525.s003
DOI:
10.1371/journal.pone.0258525.s004
DOI:
10.1371/journal.pone.0258525.s005
DOI:
10.1371/journal.pone.0258525.s006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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