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Impact of multivessel revascularization on health status outcomes in patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease.
- Source :
-
Journal of the American College of Cardiology (JACC) . Nov2015, Vol. 66 Issue 19, p2104-2113. 10p. - Publication Year :
- 2015
-
Abstract
- <bold>Background: </bold>Up to 65% of patients with ST-segment elevation myocardial infarction (STEMI) have multivessel coronary artery disease (MVCAD). Long-term health status of STEMI patients after multivessel revascularization is unknown.<bold>Objectives: </bold>This study investigated the relationship between multivessel revascularization and health status outcomes (symptoms and quality of life [QoL]) in STEMI patients with MVCAD.<bold>Methods: </bold>Using a U.S. myocardial infarction registry and the Seattle Angina Questionnaire (SAQ), we determined the health status of patients with STEMI and MVCAD at the time of STEMI and 1 year later. We assessed the association of multivessel revascularization during index hospitalization with 1-year health status using multivariable linear regression analysis, and also examined demographic, clinical, and angiographic factors associated with multivessel revascularization.<bold>Results: </bold>Among 664 STEMI patients with MVCAD, 251 (38%) underwent multivessel revascularization. Most revascularizations were staged during the index hospitalization (64.1%), and 8.0% were staged after discharge, with 27.9% performed during primary percutaneous coronary intervention. Multivessel revascularization was associated with age and more diseased vessels. At 1 year, multivessel revascularization was independently associated with improved symptoms (4.5 points higher SAQ angina frequency score; 95% confidence interval [CI]: 1.0 to 7.9) and QoL (6.6 points higher SAQ QoL score; 95% CI: 2.7 to 10.6). One-year mortality was not different between those who did and did not undergo multivessel revascularization (3.6% vs. 3.4%; log-rank test p = 0.88).<bold>Conclusions: </bold>Multivessel revascularization improved angina and QoL in STEMI patients with MVCAD. Patient-centered outcomes should be considered in future trials of multivessel revascularization. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CORONARY heart disease complications
*CORONARY heart disease surgery
*MYOCARDIAL infarction complications
*COMPARATIVE studies
*CORONARY disease
*ELECTROCARDIOGRAPHY
*HEALTH status indicators
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*MYOCARDIAL infarction
*MYOCARDIAL revascularization
*QUESTIONNAIRES
*RESEARCH
*RESEARCH funding
*EVALUATION research
*RANDOMIZED controlled trials
*TREATMENT effectiveness
*ACQUISITION of data
Subjects
Details
- Language :
- English
- ISSN :
- 07351097
- Volume :
- 66
- Issue :
- 19
- Database :
- Academic Search Index
- Journal :
- Journal of the American College of Cardiology (JACC)
- Publication Type :
- Academic Journal
- Accession number :
- 110576387
- Full Text :
- https://doi.org/10.1016/j.jacc.2015.08.873