Optimal timing of staged percutaneous coronary intervention in ST-segment elevation myocardial infarction patients with multivessel disease

BackgroundStudies 证明了为非犯人损害的上演经皮的冠的干预(一种总线标准) 为圣片断举起的预后是有益的有 multivessel 的心肌的梗塞(STEMI ) 病人疾病。然而，上演 revascularization 的最佳的预定仍然是争论的。这研究试图 428 STEMI 发现上演 revascularization.MethodsA 的最佳的预定全部经历了主要一种总线标准并且上演了一种总线标准的有 multivessel 疾病的病人被包括。根据在主要、上演的一种总线标准之间的时间间隔，病人们被划分成三个组(在主要一种总线标准以后的 1 个星期， 1-2 星期，和 2-12 星期) 。主要端点是主要不利心血管的事件(向) ，一所有原因死亡，非致命的重新梗塞，重复 revascularization，和击合成。考克斯回归模型被用来估计在预定的上演一种总线标准和 MACE.ResultsDuring 的风险之间的协会后续， 119 个参加者有权标。在在三个组之中的向发生有统计差别(1 个星期：23.0% ；1-2 星期：33.0% ；2-12 星期：40.0% ；P = 0.001 ) 。在 multivariable 调整模型，上演一种总线标准 1 星期和 1-2 星期的预定间隔是显著地与向的更低的风险联系的两个[危险比率(HR ) ：0.40， 95% 信心间隔(CI ) ：0.24-0.65；HR：0.54， 95% CI：0.31-0.93，分别地] ，主要归因于重复 revascularization 的更低的风险(HR：0.41， 95% CI：0.24-0.70；HR：0.36， 95% CI：0.18-0.7 ) ，与主要 PCI.ConclusionsThe 以后的 2-12 星期的策略相比，为非犯人容器的上演一种总线标准的最佳的预定应该在在为 STEMI 病人的主要一种总线标准以后的二个星期以内。

Background Studies have shown that staged percutaneous coronary intervention （PCI） for non-culprit lesions is beneficial for prog- nosis of ST-segment elevation myocardial infarction （STEMI） patients with multivessel disease. However, the optimal timing of staged re- vascularization is still controversial. This study aimed to find the optimal timing of staged revascularization. Methods A total of 428 STEMI patients with multivessel disease who underwent primary PCI and staged PCI were included. According to the time interval between primary and staged PCI, patients were divided into three groups （〈 1 week, 1- weeks, and 2-12 weeks after primary PCI）. The primary endpoint was major adverse cardiovascular events （MACE）, a composite of all-cause death, non-fatal re-infarction, repeat revascularization, and stroke. Cox regression model was used to assess the association between staged PCI timing and risk of MACE. Results During the follow-up, 119 participants had MACEs. There was statistical difference in MACE incidence among the three groups （〈 1 week： 23.0%; 1-2 weeks： 33.0%; 2-12 weeks： 40.0%; P = 0.001）. In the multivariable adjustment model, the timing interval of staged PCI ≤ 1 week and l-2 weeks were both significantly associated with a lower risk of MACE [hazard ratio （HR）： 0.40, 95% confidence intervals （CI）： 0.24-4）.65; HR： 0.54, 95% CI： 0.3 lq3.93, respectively], mainly attributed to a lower risk of repeat revascularization （HR： 0.41, 95% CI： 0.24-0.70; HR： 0.36, 95% CI： 0.18-0.7）, compared with a strategy of 2-12 weeks later of primary PCI. Conclusions The optimal timing of staged PCI for non-culprit vessels should be within two weeks after primary PCI for STEMI patients.