Culprit Only versus Total Revascularization in Acute Coronary Syndrome Patients Presented with Cardiogenic Shock with Multivessel Disease | ||
| SVU-International Journal of Medical Sciences | ||
| Volume 8, Issue 1, January 2025, Pages 444-451 PDF (277 K) | ||
| Document Type: Original research articles | ||
| DOI: 10.21608/svuijm.2025.340077.2033 | ||
| Author | ||
| Sherif Mohamed Hamada* | ||
| Cardiology Department, Faculty of Medicine Al- Azhar University (Assiut Branch), Assiut, Egypt | ||
| Abstract | ||
| Background: Acute coronary syndrome (ACS) with multivessel disease )MVD( and cardiogenic shock (CS) represents a higher cardiovascular risk, and revascularization strategy in such patients remains a subject of conflict. Objectives: This work investigated total revascularization benefits and safety compared to culprit-only revascularization in ACS, MVD, and CS patients. Patients and methods: This prospective randomized study was performed on 130 patients, aged ≥ 18 years old, both sexes, with ACS with MVD and CS and diagnosed with significant lesions (>70% stenosis in the major coronary vessel) in one or more coronary vessels. Patients were grouped into two equal groups: patients undergoing culprit revascularization in Group CR and those undergoing total revascularization in Group TR. Results: Procedure time, the number of stents and contrast used, and left ventricular ejection fraction were significantly increased in group TR compared with group CR (P <0.001). Cardiac mortality in hospitals, at 1m, 6m, and 1y, were insignificantly different between groups. Repeat myocardial infraction (MI) /ACS at 1m, 6m, and 1y were comparable between both groups. All cause mortality, repeat MI /ACS, and revascularization at 1y were significantly decreased in group TR compared with group CR (P <0.05). Conclusions: In ACS with MVD and CS, total revascularization is superior to culprit-only revascularization, as evidenced by better cardiac motility, lower all cause mortality, total repeat MI /ACS, and revascularization incidence. | ||
| Keywords | ||
| Acute coronary syndrome; Cardiogenic shock; Multivessel disease; Mortality; Revascularization | ||
|
Statistics Article View: 37 PDF Download: 20 |
||
