Purpose: We evaluate the efficacy of ‘culprit vessel only’ versus complete revascularization using drug-eluting stents (DES) for treatment of acute coronary syndrome (ACS) with multivessel coronary artery disease.
Methods: We retrospectively analyzed 187 patients (mean age 60±11 years) of acute coronary syndrome with multivessel disease suitable for stent deployment. Patients were divided into two groups; group 1 (n=108) underwent percutaneous coronary intervention (PCI) for culprit vessel only with DES, and group 2 (n=79) underwent complete revascularization with at least two DES. The culprit vessel was defined by reviewing pateint’s coronary angiogram, electrocardiogram, echocardiogram and/or nuclear stress test. MACE (myocardial infarction, CVA, or death) and the incidence of revascularization of culprit and non-culprit vessel(s) were evaluated. Mean follow-up duration was 26±21 months.
Results: There was no significant difference of baseline clinical and angiographic characteristics between two groups, and there were no significant difference between two groups in MACE; 13 (11.5%) in group 1 and 6 (8.2%) in group 2 (p=0.695). In the rate of non-culprit vessel(s) revascularization, group 1 showed higher than group 2 (n=45 [60.4%] vs. 14 [29.7%], respectively, p<0.001), while there was no significant difference in the rate of culprit vessel revascularization (group 1; n=16 [21.3%], group 2: n=20 [33.9%]. p=0.119).
Conclusion: Based on this study, in clinical practice, we should positively consider DES-based complete revascularization rather than ‘culprit vessel only’ revascularization for the treatment of acute coronary syndrome with multivessel disease suitable for stent deployment.
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