Furthermore,
Does full revascularization really do:
During a infarction associated with multiple coronary lesions. Nevertheless, the complete revascularization reduces reinterventions to 10 years but does not improve survival or the risk of recurrence, questioning its real clinical benefit.
In the event of myocardial infarction with aforementioned ST segment (IDM ST+) with multiple coronary lesions. Similarly, full revascularization is recommended rather than a revascularization limited to the only artery responsible for the acute event. Moreover, This multiple revascularization requires a longer intervention time, and the installation of multiple stents. In addition. Therefore, the long -term becoming of complete revascularizations remains poorly documented in patients with an IDM ST+ associated with multi -off stenosis.
Marquard et al. Moreover, wanted to determine. in patients hospitalized for an IDM ST+, the prognosis at 10 years of a complete coronary revascularization compared to the revascularization of the only coronary artery responsible for the IDM ST+.
More than 600 does full revascularization really do patients followed for 10 years
The Danami-3-Primulti study included 627 patients who had an IDM ST+. a significant stenosis on at least one artery not responsible for infarction. After randomization. patients benefited either from a complete PCI (interventional coronary procedure) on all coronary stenosis (n = 314) or a PCI limited to the only responsible artery of infarction (n = 313); In all cases the PCI was guided by a measurement of the fractional reserve flow. The follow -up period extended to 10 years.
The main evaluation criterion was a composite associating mortality of any cause, recurrence of the infarction, any revascularization. The authors also analyzed the iterative events linked to a new revascularization or the recurrence of the infarction.
A decrease in revascularizations at 10 years
After the 10 years of follow -up. complete revascularization was associated with a significant reduction in the impact of the main criterion (HR 0.76 [IC 95 % does full revascularization really do : 0,60-0,94] ; p = 0.014) thanks to a decrease in iterative revascularizations.
In the group which benefited from the only revascularization of the artery responsible for infarction. 78 patients (25 %) died during the follow -up versus 74 (24 %) in the full revascularization group. Complete revascularization (vs The revascularization of the only responsible artery) has reduced the risk of any new revascularization (gold: 0.62 [0,44-0,89]). No difference was observed in recurrence of the infarction (gold: 0.90 [0,60-1,35]).
The cumulative number of cardiac events was 76/100 people (95 % CI: 66-88) in the Revascularization of the only. responsible artery of the infarction vs 63 events/100 people (95 % CI: 54–73) in the full revascularization group (absolute reduction: 13 % [-1 % à 28 %]).
In conclusion. complete revascularization (compared to the revascularization of the only responsible artery of infarction) reduces, but only after 10 years, iterative revascularizations, without significant reduction in does full revascularization really do the incidence of infarction and mortality.
Does full revascularization really do
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