Comparison of Clinical Outcomes Between Incomplete and Complete Revascularization in NSTEMI Patients With Multivessel Disease
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The optimal revascularization strategy for patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel disease remains controversial. OBJECTIVES: This study aimed to compare the 3-year clinical outcomes of incomplete revascularization (IR) vs complete revascularization (CR) in NSTEMI patients with multivessel disease. METHODS: Among 29,625 patients enrolled in the nationwide pooled registry of the KAMIR-NIH (Korea Acute Myocardial Infarction Registry-National Institutes of Health) and KAMIR-V, 6,987 NSTEMI patients with multivessel disease who underwent percutaneous coronary intervention were analyzed. CR was defined as residual stenosis <30% in all vessels ≥2.25 mm with TIMI flow grade 3. The primary endpoint was major adverse cardiac events at 3 years, a composite of all-cause death, recurrent myocardial infarction, unplanned repeat revascularization, and hospitalization for heart failure. RESULTS: Of 6,987 patients, 3,072 underwent CR and 3,915 IR. The majority of patients underwent percutaneous coronary intervention for non-infarct-related artery during index procedure (6,144 of 6,987; 88.0%). CR was associated with a lower 3-year risk of major adverse cardiac events compared with IR (18.6% vs 26.9%; adjusted HR: 0.75; 95% CI: 0.66-0.85; P < 0.001), driven by reductions in cardiac death or recurrent myocardial infarction (6.9% vs 10.4%; adjusted HR: 0.76; 95% CI: 0.60-0.95; P = 0.015) and unplanned repeat revascularization (8.6% vs 13.1%; adjusted HR: 0.68; 95% CI: 0.56-0.82; P < 0.001). Findings were consistent after adjustment using propensity score matching and inverse probability weighting. CONCLUSIONS: In NSTEMI patients with multivessel disease, CR was associated with significantly improved 3-year clinical outcomes compared with IR.
Source: JACC Asia
Authors: Chang Hoon Kim, Hyun Sung Joh, Hyun Kuk Kim, Ju Han Kim, Young Joon Hong, Youngkeun Ahn, Myung Ho Jeong, Seung Ho Hur, Doo-Il Kim, Kiyuk Chang, Hun Sik Park, Jang-Whan Bae, Jin-Ok Jeong, Yong Hwan Park, Kyeong Ho Yun, Chang-Hwan Yoon, Yisik Kim, Jin-Yong Hwang, Hyo-Soo Kim, Ki Hong Choi, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Seung Hun Lee, Joo Myung Lee
Institutions: Jeonbuk National University Hospital, Seoul National University, SNUH SMG-SNU Boramae Medical Center, Chosun University, Seoul National University Hospital, Chosun University Hospital, Chonnam National University, Chonnam National University Hospital, Keimyung University Dongsan Medical Center, Keimyung University Dongsan Hospital, Inje University, The Catholic University of Korea Seoul St. Mary's Hospital, Catholic University of Korea, Kyungpook National University Hospital, Kyungpook National University, Chungbuk National University, Chungnam National University, Chungnam National University Hospital, Samsung Changwon Hospital, Sungkyunkwan University, Wonkwang University Hospital, Seoul National University Bundang Hospital, Gyeongsang National University, Gyeongsang National University Hospital, Samsung Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,084
OpenAlex ID: W7147476559