The relationship between culprit artery and the clinical outcomes in patients undergoing primary percutaneous coronary ıntervention for ınferior wall ST segment elevation myocardial ınfarction.

BACKGROUND

We observed the effect of culprit artery in patients undergoing primary percutaneous coronary intervention (PCI) caused by inferior wall ST elevation myocardial infarction (STEMI) during hospital stay and 6-month follow-ups.

METHODS

After exclusion, 233 consecutive patients with inferior wall STEMI (mean age: 55.6±12.4 years) undergoing primary PCI were prospectively enrolled in this study. Patients were divided into two groups according to culprit artery: right coronary artery (RCA=group 1 [N.=187]) and left circumflex artery (LCX=group 2 [N.=46]). Patients were followed up for six months.

RESULTS

Patients of both groups had similar risk factors such as age, sex, hypertension and diabetes mellitus. While there were more cases of right ventricular infarction (P=0.001), complete atrioventricular block (P=0.002) and proximal located lesions (P=0.002) in RCA group, there was less collateral circulation incidence in LCX group (P=0.04). Ratios of no-reflow and myocardial blush grade after primary PCI were similiar in both groups. There was no significant difference between groups associated with major adverse cardiac events (MACE), target-vessel revascularization and mortality ratios during hospital stay and 6-month follow-up period.

CONCLUSIONS

The impact of RCA and LCX on MACE and cardiovascular mortality during hospital stay and the 6-month follow-up (mid-term) period are similar in patients on whom primary PCI was performed due to inferior wall STEMI.