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Shishehbor, Mehdi H., DO, MPH; Lauer, Michael S., MD, FACC; Singh, Inder M., MD, MS; Chew, Derek P., MBBS, MPH; Karha, Juhana, MD; Brener, Sorin J., MD, FACC; Moliterno, David J., MD, FACC; Ellis, Stephen G., MD, FACC; Topol, Eric J., MD, FACC; Bhatt, Deepak L., MD, FACC
Journal of the American College of Cardiology, 02/2007, Volume: 49, Issue: 8Journal Article
In Unstable Angina or Non–ST-Segment Acute Coronary Syndrome, Should Patients With Multivessel Coronary Artery Disease Undergo Multivessel or Culprit-Only Stenting? Mehdi H. Shishehbor, Michael S. Lauer, Inder M. Singh, Derek P. Chew, Juhana Karha, Sorin J. Brener, David J. Moliterno, Stephen G. Ellis, Eric J. Topol, Deepak L. Bhatt We examined the safety and efficacy of nonculprit multivessel compared with culprit-only stenting in patients who had multivessel disease that presented with non–ST-segment elevation myocardial infarction (NSTEMI). From January 1995 to June 2005, 479 patients underwent multivessel and 761 patients underwent culprit-only stenting and met our study criteria. Multivessel intervention was associated with lower death, myocardial infarction, or revascularization after both adjusting for baseline and angiographic characteristics (hazard ratio 0.80; 95% confidence interval, 0.64 to 0.99; p = 0.04) and propensity matched analysis (hazard ratio 0.67; 95% confidence interval 0.51 to 0.88; p = 0.004). In patients with multivessel coronary artery disease presenting with NSTEMI, multivessel intervention was significantly associated with a lower incidence of the composite end point compared with culprit-only stenting.
