Author + information
- Uwe Zeymer,
- Mathias Hochadel,
- Harald Darius,
- Johannes Brachmann,
- K. Hauptmann,
- Ralf Zahn and
- Klinikum Ludwigshafen
There is still uncertainty about the optimal strategy in patients with multivessel disease undergoing primary PCI for cardiogenic shock. Therefore we compared outcome of patients with culprit lesion only PCI and immediate multivessel PCI for cardiogenic shock in real life.
We used the data of the prospective ALKK–PCI registry and included patients with primary PCI for cardiogenic shock with 2–3 vessel disease. We excluded patients with left main PCI and patients with prior coronary artery bypass surgery.
Between 2008 and 2010 a total of 742 patients 2–3 vessel disease were treated with primary PCI for cardiogenic shock. Of these 176 (24%) received immediate multivessel PCI while in the remaining only the culprit vessel was treated.
Baseline characteristics, procedural features and outcomes are given in the table.
Immediate multivessel PCI for cardiogenic shock used in about 25 % of patients is associated with similar success rates as culprit lesion PCI, but with a higher mortality. Therefore a randomized trial seems warranted to evaluate the optimal interventional strategy in these patients.
|Culprit lesion PCI (n=566)||Multivessel PCI (n=176)||p-value|
|Diabetes||38 %||35 %||0.5|
|Renal insuffiency||50 %||39 %||0.01|
|STEMI||77 %||69 %||0.02|
|3-vessel disease||62 %||69 %||0.7|
|TIMI 3 after PCI||80 %||82 %||0.3|
|IABP||26 %||33 %||0,03|
|Contrast medium (ml)||170||228||< 0.001|
|Inhospital Ddeath||35.6 %||46.9 %||0.007|
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Multivessel Disease
Abstract Category: 45. TCT@ACC–i2: Coronary Intervention, Multivessel disease
Presentation Number: 2104M–252
- 2013 American College of Cardiology Foundation