Key result
Multivessel PCI linked to no mortality benefit over culprit-only PCI in STEMI, cardiogenic shock, and MVD.
Why the study?
Multivessel primary PCI is still often used in patients with STEMI and cardiogenic shock, but characteristics and prognosis compared to culprit vessel-only primary PCI required evaluation.
Does multivessel primary PCI reduce 30-day and 1-year all-cause mortality compared to culprit vessel-only primary PCI in patients with STEMI, cardiogenic shock, and multivessel coronary disease?
Observational (n=1,213)
Yes
Does multivessel primary PCI reduce 30-day and 1-year all-cause mortality compared to culprit vessel-only primary PCI in patients with STEMI, cardiogenic shock, and multivessel coronary disease?
Effect estimate: OR 1.01 (95% CI 0.77-1.32)
p-value: p=0.937
In a national registry of patients with STEMI, cardiogenic shock, and multivessel disease, selective use of multivessel primary PCI during the initial procedure was associated with similar 30-day and 1-year all-cause mortality compared to culprit vessel-only PCI.
Similar mortality observed with multivessel PCI; leaves open its role pending randomized trials in STEMI with shock and MVD.
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Hlinomaz et al. (2023) conducted an observational in ST-elevation myocardial infarction with cardiogenic shock and multivessel coronary disease (n=1,213). Multivessel primary PCI vs. Culprit vessel-only primary PCI was evaluated on 30-day all-cause mortality (OR 1.01, 95% CI 0.77-1.32, p=0.937). Multivessel primary PCI resulted in similar 30-day (OR 1.01; 95% CI 0.77-1.32) and 1-year all-cause mortality compared to culprit vessel-only PCI in patients with STEMI, cardiogenic shock, and MVD.
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