Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Culprit vessel only versus multivessel angioplasty for hemodynamically stable patients with ST-segment elevation myocardial infarction and multivessel disease
Session:
Posters 3 - Écran 1 - Doença Coronária
Speaker:
Liliana Rafaela Teles Reis
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.4 Acute Coronary Syndromes – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Liliana Reis; Luis Paiva; Marta Madeira; Marco Costa; Carolina Lourenço; Fátima Loureiro; Lino Gonçalves
Abstract
<p><strong>Background:</strong> Multivessel disease (MVD) in ST-elevation myocardial infarction (STEMI) is associated with a worse prognosis. A multivessel approach at the time of primary percutaneous coronary intervention (PCI) is the subject of debate. The objective of this study was to access the prognostic impact of multivessel intervention (MVI) at the time of primary PCI (MVI-P) or staged during the index admission (MVI-S) <em>versus</em> culprit vessel-only PCI (CVI) in registry of acute coronary syndromes (ACS) and multivessel disease.</p> <p><strong>Methods:</strong> A retrospective cohort study of 7766 patients with STEMI diagnosis who underwent primary PCI between October 2010 and July 2018, from the Portuguese Registry of Acute Coronary Syndromes (ACS). About 33% patients had MVD. We performed a propensity score matched analysis to obtain 2 groups of patients paired according to whether or not they had undergone multivessel PCI or culprit vessel-only PCI. We also explored this relationship across various patients’ subgroups and performed stratified analyses according to the revascularization strategies of nonculprit lesions.</p> <p> </p> <p><strong>Results:</strong> Compared with MVI, after propensity score matching, CVI patients presented similar in-hospital mortality and MACE at index admission. However, follow-up mortality was higher in the CVI group (9.4% vs 4.1%, p=0.016). Comparing CVI with MVI-P, we verified that in-hospital mortality was similar in both groups (6.1% vs 5.5%, P = 0.720); but the occurrence of major bleeding was more prevalent in CVI patients (1.3% vs 0.0%, P = 0.029). Follow-up mortality was more frequent in these group (8.6% vs 3.6%, P = 0.012), without differences in cardiovascular re-hospitalization. Comparing CVI with MVI-S, culprit only cases were associated with increase in-hospital mortality (6.1% vs 0.7%, P < 0.001), shock cardiogenic (6.8% vs 3.1%, P = 0.001) and follow-up mortality (8.6% vs 2.9%, P = 0.032). Regarding MVI subgroups, MVI-P was associated with higher in-hospital mortality (5.5% vs 0.7%, P = 0.001) and shock cardiogenic (8.0% vs 3.1%, P = 0.008) than MVI-S.</p> <p><strong>Conclusions:</strong> In a real-world registry of patients presenting with STEMI and MVD, complete percutaneous revascularization reduced death after hospital discharge. A staged MVI strategy showed an early clinical impact compared to MVI at the time of primary PCI.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site