Culprit Vessel v Multivessel Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction - The Waikato Experience

Aim: The optimal strategy for treating non culprit disease in ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) remains to be defined with up to two-thirds having significant disease present in one or more non-infarct-related arteries. This study provides a real-world analysis comparing a strategy of culprit vessel only (CVO) versus multivessel PCI (MVPCI) at the time of index procedure (IP) in patients with STEMI and MVD. This is a retrospective observational study comparing clinical outcomes in culprit vessel only (CVO) with multivessel PCI (MVPCI) for treatment of patients with STEMI and MVD. Method: A total of 73 STEMI patients with MVD were identified from the Waikato Hospital STEMI database treated in 2015 and underwent CVO or MVPCI at the time of IP. Outcomes including mortality, myocardial infarction (MI) and repeat revascularisation at 12 months were collected from hospital electronic medical records, telephonic calls to patients and their general practitioners. Results: Out of the total 73 patients, 53(72.60%) were males and 20(27.39%) females with a mean age of 66.08 ± 10.48 SD. There were 53(72.60%) patients in the CVO group and 20(27.39%) in the MVPCI group. The outcomes in CVO and MVPCI groups for mortality, revascularisation and MI showed no significant differences (13.21%vs 20%, 16.98% vs. 15% and 28.3% vs. 30%; p = 0.706, 0.434 and0.762 respectively). Conclusion: In patients presenting with STEMI at Waikato Hospital, CVO revascularisation has similar outcomes when compared with MVPCI. Ongoing studies are awaited to inform guidelines.