Prognosis Analyze Of Different Revascularization Stages To Non-IRA In Patients With ST-segment Elevation Myocardial Infarction And Multivessel Coronary Artery Disease

Objective:To analyze the prognosis of different treatment strategies andrevascularization stages to non-IRA in patients with ST-segment elevation myocardialinfarction and multivessel coronary artery disease.Methods:1.272patients who had underwent primary PCI in Fujian Provincialhospital from January2000to December2012were selected.According to thedifferent revascularization strategies to non-IRA,these patients were divided intoComplete revascularization group(CR group)and Incomplete revascularizationgroup(ICR group).the clinical outcomes of these patients were collected thoughfollow-up and compared though Logistic analysis.2.patients selected from the firststep study were divided into Selective CR group(SCR group)and ICR group,prognosiswere compared though Logistic analysis;3.The patients of SCR group were dividedinto early SCR group(SCR-E group)and late SCR group(SCR-L group)according tothe time of non-IRA revascularization,prognosis were compared though Chi-squareStatistical methods.Results:1.There was no statistically significant difference between the CR groupand ICR group in cardiac causes mortality,in-hospital cardiac causesmortality,long-term cardiac causes mortality,All-cause mortality,the incidence ofMACEs and repeat PCI;the difference in incidence of angina recurrence wasstatistically significant (P=0.036);2.the difference between the SCR group and ICRgroup in cardiac causes mortality,in-hospital cardiac causes mortality,long-termcardiac causes mortality,All-cause mortality,the incidence of MACEs and repeat PCIwas no statistically significant;the difference in incidence of angina recurrence wasstatistically significant (P=0.045);3.the difference between the SCR-E group andSCR-L group in the incidence of MACEs,repeat PCI and angina recurrence was nostatistically significant;the SCR-L group had lower All-cause mortality,the difference was statistically significant(P=0.044),and had a tendency to reduce cardiac causesmortality,but the difference was no statistically significant(P=0.09).Conclusion:1.In patients with STEMI and multivessel coronary artery diseaseundergoing primary PCI,complete revascularization and selective completerevascularization to non-IRA with severe stenosis significantly reduce the risk ofangina recurrence,but had no significant effect on reducing cardiac causesmortality,in-hospital mortality,long-term mortality,All-cause mortality,the incidence ofMACEs and repeat PCI;2. Late selective complete revascularization reduced the riskof All-cause mortality,and had a tendency to reduce cardiac causes mortality.