NON-INFARCT-RELATED CORONARY ARTERY DISEASE AND EARLY MORTALITY AMONG PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION TREATED WITH PRIMARY PERCUTANEOUS CORONARY INTERVENTION

The objective of this paper is to analyze incidence and location of non infarct-related-artery (non-IRA) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI) and to correlate data with early mortality. Angiographic (IRA and non-IRA) and clinical data of 527 patients, admitted consecutively for STEMI and treated with pPCI in single tertiary centre from 2008 to 2011 were studied. In-hospital, 30-day out-of-hospital and 30-day cumulative mortality were compared according presence of non-IRA disease. Overall 295 patients (56%) had significant non-IRA disease. In-hospital and 30-day cumulative mortality rates were significantly higher in patients with non-IRA disease (odds ratio (OR) 2.74; confidence interval (CI) 1.08-6.94). Left main artery stenosis >= 30% is a risk factor for early mortality (OR 5.57; 95% CI 2.27-13.68). There was not significant correlation with high grade stenosis and chronic total occlusions (CTO) of other arteries. Single centre analysis of non-IRA disease in STEMI patients revealed significant increase of 30-day mortality. Results from clinical trials are needed for validation of non-IRA revascularization treatment algorithms.