News | March 26, 2010

More Research Needed for Best Treatment of Multivessel Disease During STEMI

March 26, 2010 – Nearly 14 percent of Medicare beneficiaries admitted with a primary diagnosis of ST-elevated myocardial infarction (STEMI) undergo multivessel primary percutaneous coronary intervention (PCI), despite recommendations from the American College of Cardiology and the American Heart Association to intervene on only the culprit vessel.

Those patients undergoing multivessel intervention experience higher unadjusted morbidity/mortality than those patients undergoing single vessel PCI. However, multivessel PCI was not a significant predictor of mortality once comorbid conditions were controlled in the regression model. These are among the findings of new research presented by Aaron D. Kugelmass, M.D., Baystate Medical Center, Springfield, Mass., at the American College of Cardiology's Scientific Sessions 2010 in Atlanta.

According to the study, STEMI patients undergoing multivessel PCI were more likely to be male, experience cardiogenic shock and have a drug-eluting stent. They also experience increased unadjusted in-hospital mortality, are more likely to experience acute renal failure, and have a lower incidence of coronary artery bypass graft surgery (CABG) than those undergoing single vessel PCI.

The research, funded and conducted by Cardiac Data Solutions, studied data on Medicare beneficiaries (MB) with a primary diagnosis of STEMI (first diagnosis code) that underwent a PCI during hospitalization between Oct. 1, 2006 and Sept. 30, 2007 and included 24,189 MB.

The study compared the following clinical outcomes between the MB undergoing single-vessel versus multivessel PCI:

• Acute renal failure
• New-onset hemodialysis
• Any vascular complication
• Observed mortality
• Expected mortality
• Stent type and usage

"The study supports the current recommendations that STEMI patients undergo culprit vessel PCI only, however, prospective assessment of this question is needed to identify the best treatment strategy for patients with STEMI and multivessel CAD," said April Simon, RN, MSN, president of Cardiac Data Solutions and one of the researchers.

Other researchers included: Phillip P. Brown, cardiovascular surgeon (retired) and past chairman, department of surgery, Centennial Medical Center; David J. Cohen, M.D., interventional cardiologist and director, cardiovascular research, Mid America Heart Institute, St. Luke's Hospital; Matthew R. Reynolds, M.D., electrophysiologist and director, Economics and Quality of Life Assessment Group, Harvard Clinical Research Institute; and Steven D. Culler, Ph.D., associate professor, Rollins School of Public Health, Emory University.

Cardiac Data Solutions provides consultation services, data analysis, clinical benchmarks, management tools, research support services and leadership training to hospitals, physicians, payors, manufacturers and the financial community.

For more information: http://tinyurl.com/ycue7xb, www.cardiacdatasolutions.com/cds/jsp/documents/Multi-Vessel%20Primary%20PCI%20Avisable%20%20Differences%20in%20Clinical%20Outcomes%20amongv4%20%20%20%20%20.pdf

Related Content

Bivalirudin exhibited an improvement in 30-day all-cause mortality when injected post PCI.
News | Antiplatelet and Anticoagulation Therapies| August 16, 2017
August 16, 2017 — A study has examined the efficacies of various post-percutaneous coronary intervention (PCI) bivali
CMS considers eliminating cardiac bundled payments.
Feature | Business| August 16, 2017 | Dave Fornell
August 16, 2017 — The Centers for Medicare and Medicaid Services (CMS) announced a proposed rule to reduce the number
ESC 2017 late breaking trial hot line study presentations.
News | Clinical Study| August 16, 2017
Aug. 16, 2017 – The European Society of Cardiology (ESC) Congress 2017 includes several Hot Line Late-breaking Clinic
News | Drug-Eluting Balloons| August 15, 2017
Surmodics Inc. announced receipt of an investigational device exemption (IDE) from the U.S. Food and Drug...
The Vascular Dynamics MobiusHD device enhances the carotid baroreceptors to reduce resistant hypertension.
News | Hypertension| August 15, 2017
Aug. 15, 2017 — The U.S. Food and Drug Administration (FDA) has approved the Vascular Dynamics Inc.
Abbott Initiates First Clinical Trial of Clip-Based Tricuspid Repair System
News | Heart Valve Technology| August 09, 2017
Abbott announced that the first patient has been enrolled in a clinical study to evaluate a minimally invasive clip-...
Four Blue Cross Blue Shield Companies Issue Positive Medical Policies on HeartFlow FFRct Analysis
News | FFR Catheters| August 09, 2017
HeartFlow Inc. announced that four Blue Cross Blue Shield companies have each issued a positive medical policy for the...
Ra Medical Systems Granted Broad Patent for DABRA Catheter
News | Peripheral Artery Disease (PAD)| August 09, 2017
August 9, 2017 — Ra Medical Systems announced that the United States Patent and Trademark Office (USPTO) has granted
Overlay Init