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Observational Study
. 2016 Dec;107(6):550-556.
doi: 10.5935/abc.20160176.

Complete Treatment Versus Residual Lesion - Long-Term Evolution After Acute Coronary Syndrome

[Article in Portuguese, English]
Alexandre de Matos Soeiro  1 , Marco Antônio Scanavini Filho  1 , Aline Siqueira Bossa  1 , Cindel Nogueira Zullino  1 , Maria Carolina F Almeida Soeiro  1 , Tatiana Carvalho Andreucci T Leal  1 , Carlos Vicente Serrano Jr  1 , Ludhmila Abrahão Hajjar  1 , Roberto Kalil Filho  1 , Múcio Tavares Oliveira Jr  1
Affiliations
Observational Study

Complete Treatment Versus Residual Lesion - Long-Term Evolution After Acute Coronary Syndrome

[Article in Portuguese, English]
Alexandre de Matos Soeiro et al. Arq Bras Cardiol. 2016 Dec.

Abstract

Introduction: A recently published study raised doubts about the need for percutaneous treatment of nonculprit lesions in patients with acute coronary syndromes (ACS).

Methods: Retrospective, unicentric, observational study.

Objective: To analyze the long-term outcomes in patients undergoing treatment of the culprit artery, comparing those who remained with significant residual lesions in nonculprit arteries (group I) versus those without residual lesions in other coronary artery beds (group II). The study included 580 patients (284 in group I and 296 in group II) between May 2010 and May 2013. We obtained demographic and clinical data, as well as information regarding the coronary treatment administered to the patients. In the statistical analysis, the primary outcome included combined events (reinfarction/angina, death, heart failure, and need for reintervention). The comparison between groups was performed using the chi-square test and ANOVA. The long-term analysis was conducted with the Kaplan-Meier method, with a mean follow-up of 9.86 months.

Results: The mean ages were 63 years in group I and 62 years in group II. On long-term follow-up, there was no significant difference in combined events in groups I and II (31.9% versus 35.6%, respectively, p = 0.76).

Conclusion: The strategy of treating the culprit artery alone seems safe. In this study, no long-term differences in combined endpoints were observed between patients who remained with significant lesions compared with those without other obstructions.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Flowchart of inclusion/exclusion of patients in the study. ACS: acute coronary syndrome; CABG: coronary artery bypass graft; LMCA: left main coronary artery; PCI: percutaneous coronary intervention.
Figure 2
Figure 2
Comparison of percentage free of long-term combined events in group I (with residual lesion) and II (without residual lesion).
Figure 3
Figure 3
Comparison of long-term survival between group I (with residual lesion) and II (without residual lesion).
See this image and copyright information in PMC

References

    1. Gara PT, Kushner FG, Ascheim DD, Casey Jr DE, Chung MK, de Lemos JA, et al. American College of Cardiology Foundation. American Heart Association Task Force on Practice Guidelines 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127(4):e362–e425. Erratum in: Circulation. 2013;128(25):e481. - PubMed
    1. Steg G, James SK, Atar D, Badano LP, Blomstrom-Lundqvist C, Borger MA, et al. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33(20):2569–2619. - PubMed
    1. Piegas LS, Timerman A, Feitosa GS, Nicolau JC, Mattos LAP, Andrade MD, et al. V Diretriz da Sociedade Brasileira de Cardiologia sobre tratamento do infarto agudo do miocárdio com supradesnível do segmento ST. Arq Bras Cardiol. 2015;105(2):1–105. - PubMed
    1. Hannan EL, Samadashvili Z, Walford G, Holmes Jr DR, Jacobs AK, Stamato NJ, et al. Culprit vessel percutaneous coronary intervention versus multivessel and staged percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel disease. JACC Cardiovasc Interv. 2010;3(1):22–31. - PubMed
    1. Zhang D, Song X, Lv S, Yuan F, Xu F, Zhang M, et al. Culprit vessel only versus multivessel percutaneous coronary intervention in patients presenting with ST-segment elevation myocardial infarction and multivessel disease. PLoS One. 2014;9(3):e92316. Erratum in: PLoS One. 2014;9(12):e116450. PLoS One. 2014;9(6):e101073. - PMC - PubMed

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