Key result
Multivessel revascularization significantly reduced the composite rate of death, myocardial infarction, or any revascularization compared to single-vessel revascularization (6.89% vs. 30.77%, p=0.001).
Why the study?
Diabetic patients with NSTEMI and multivessel coronary artery disease present unique challenges in revascularization strategy selection.
Does multivessel percutaneous coronary intervention reduce major adverse cardiovascular and cerebrovascular events compared to single-vessel intervention in diabetic patients with NSTEMI and multivessel disease?
Observational (n=110)
No
Does multivessel percutaneous coronary intervention reduce major adverse cardiovascular and cerebrovascular events compared to single-vessel intervention in diabetic patients with NSTEMI and multivessel disease?
In diabetic patients with NSTEMI and multivessel disease, a multivessel PCI strategy significantly reduces short-term MACCE compared to culprit-only PCI, despite a higher risk of periprocedural renal dysfunction.
Supports multivessel PCI in diabetic NSTEMI; leaves open confirmation by randomized trials before practice change.
Background: Diabetic patients with non-ST-elevation myocardial infarction (NSTEMI) and multivessel coronary artery disease (MVD) present unique challenges in revascularization strategy selection. This study compares the clinical outcomes of multivessel (MVR) versus single-vessel revascularization (SVR) using percutaneous coronary intervention (PCI) in such patients. Methods: A prospective observational study was conducted at a tertiary center in Bangladesh including 110 diabetic NSTEMI patients with angiographically confirmed MVD. Patients underwent either MVR (n=58) or SVR (n=52). Outcomes assessed over a 6-month follow-up included major adverse cardiovascular and cerebrovascular events (MACCE), left ventricular ejection fraction (LVEF), functional capacity (METS), and survival. Results: Baseline characteristics were comparable between groups. The MVR group had significantly more stents (2.36±0.49 vs. 1.17±0.38; p<0.01) and longer stent length (58.76±10.22 mm vs. 33.46±10.93 mm; p<0.01). MACCE was significantly lower in the MVR group (6.89% vs. 30.77%; p=0.001), with reduced myocardial infarction and revascularization rates. Both groups showed significant improvement in LVEF and METS post-PCI, with no significant intergroup difference. Kaplan–Meier analysis revealed superior event-free survival in the MVR group. Conclusions: Multivessel PCI offers superior clinical outcomes and event-free survival in diabetic NSTEMI patients with MVD, without increasing periprocedural risks. Individualized risk-benefit assessment remains essential.
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Alam et al. (2025) conducted an observational in Non-ST-elevation myocardial infarction (NSTEMI) with multivessel disease in diabetic patients (n=110). Multivessel revascularization (MVR) vs. Single-vessel revascularization (SVR) was evaluated on Composite of death, myocardial infarction, or any revascularization (p=0.001). Multivessel revascularization significantly reduced the composite rate of death, myocardial infarction, or any revascularization compared to single-vessel revascularization (6.89% vs. 30.77%, p=0.001).
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