Effects of simultaneous or elective percutaneous coronary intervention for non-infarction related artery on clinical outcome in over 70-year-old patients with acute ST-elevation myocardial infarction combined with multi-vessel lesions

Objective: To compare the effects of simultaneous or elective percutaneous coronary intervention (PCI) for treatment of non-infarction related arteries (NIRA) on clinical outcome in over 70-year-old patients with ST-elevation myocardial infarction (STEMI) combined with multi-vessel lesions. Methods: A total of 70 patients aged over 70 yeas that had acute STEMI combined with multi-vessel lesions and received PCI between January 2010 and January 2015, were enrolled in this study. According to simultaneous emergency PCI or elective PCI for treatment of NIRA, the 70 patients were divided into simultaneous PCI group and elective PCI group. Clinical outcomes were compared between the both groups during one-year follow-up. Results: There were no statistical differences in sex, age, constituent ratio of diseases, risk factors of coronary artery disease (CAD), family history of CAD, heart function, cardiac functional grading, hepato-renal function indices, medication, time interval from symptom onset to balloon dilatation, time interval from seeing doctors to balloon dilatation, and related data of emergency coronary angiography and direct PCI between the both groups (all P > 0.05). During the follow-up of 1-3 months, 3-12 months and one year, there were respectively no statistical differences in the incidences of major cardiovascular events including recrudescent angina, re-hospitalization due to cardiovascular disease, heart failure, recurrent myocardial infarction, second revascularization, severe arrhythmia, all-cause mortality and cardiovascular mortality between the two groups (all P > 0.05). Conclusion: For over 70-year-old patients who have acute STEMI combined with multi-vessel lesions and receive emergency PCI for treatment of infarction-related arteries (IRA), we propose that simultaneous emergency PCI for treatment of NIRA be adopted instead of elective PCI for treatment of NIRA because it fails to increase heart-related events and also avoids another PCI.