Turk Kardiyol Dern Ars. Ahead of Print: TKDA-59839 | DOI: 10.5543/tkda.2024.59839

Ten-year Outcomes Following Revascularization Strategies for Non-ST Segment Elevation Myocardial Infarct and Multivessel Disease

Aykut Demirkıran, Cihan Aydın, Aydın Akyüz, Şeref Alpsoy
Department of Cardiology, Tekirdag Namık Kemal University, Tekirdağ, Turkiye

OBJECTIVES
There remain conflicting recommendations regarding revascularization strategies for patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel disease (MVD). We aimed to compare the long-term outcomes of revascularization strategies.

METHODS
Patients with similar characteristics were divided into three groups: immediate complete revascularization (ICR), staged complete revascularization (SCR), and non-complete revascularization group (NCR). The SCR group was divided according to the time interval between the index and staged procedures: SCR ≤ 24 hours and SCR > 24 hours. The cardiac composite outcomes included the total number of cardiac deaths and recurrent myocardial infarction during the follow-up period.

RESULTS
316 of the 14.511 scanned patients were included for analysis. It showed that there was a significant difference in risk between SCR and ICR (HR (95% CI): 0.27 (0.15–0.47); p = 0.001). It showed that there was no significant difference between NCR and SCR (HR (95% CI): 1.06 (0.61–1.84); p = 0.832). The SCR group was divided into two groups according to the time interval from the first procedure to the second procedure (TI ≤ 24 hours in the SCR1 group, and TI > 24 hours in the SCR2 group). The frequency of cardiac composite outcomes was lower in the SCR1 than the SCR2 (%16.7 and %47.1; p = 0.038).

CONCLUSIONS
Our study results support the strategy of ICR and SCR completed within 24 hours due to its favorable long-term outcomes in patients with MVD and NSTEMI.

Keywords: Complete revascularization, infarct-related artery, multivessel disease, non-ST-segment elevation myocardial infarction, revascularization strategies

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