Prognostic factors of non-infarct-related arterial revascularization in STEMI patients with multivessel disease

Background Multivessel disease(MVD) is common in patients presenting with ST-segment elevation myocardial infarction(STEMI). But there is controversy over how to manage significant lesions in non-infarct-related artery(non-IRA). Methods A total of 221 patients diagnosed with STEMI and MVD who underwent percutaneous coronary intervention(PCI) at our cardiology department between January 2018 and June 2021 were included in this study. Among them, 115 patients underwent complete revascularization within 30 days and were assigned to the complete revascularization group, while 106 patients who did not undergo complete revascularization within 30days were assigned to the IRA-only revascularization group. Patients were followed up at 12 months. The primary endpoint event was adverse cardiovascular events(MACEs). Results There was no significant statistical difference in MACEs between the two groups of patients, but the incidence of heart failure in the IRA-Only group was significantly higher than that in the complete revascularization group. In the complete revascularization group, the number of stents, Killip class Ⅱ/Ⅲ on admission, and complete revascularization time were independent predictors of MACEs. Receiver operating characteristic curve(ROC) curve analysis showed that complete revascularization time had good predictive power for MACEs(Area under the curve: 0.746 95% CI: 0.680-0.801, with a cut-off value of 10.3 days. Conclusions For STEMI patients with concurrent MVD, complete revascularization can reduce the incidence of heart failure. What’s more, short-term staged(within 10 days) complete revascularization may further improve clinical outcomes.[S Chin J Cardiol 2023;24(2):59-64]