The relationship between culprit artery and the clinical outcomes in patients undergoing primary percutaneous coronary intervention for inferior wall ST segment elevation myocardial infarction

Abstract

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.