Left ventricular function in patients with multi-vessel coronary disease and acute STEMI: comparison with single vessel disease

Multi-vessel coronary disease may be associated with worse outcome compared to one vessel disease. However, myocardial conditioning may be associated with myocardial protection during acute myocardial ischemia. Aim: To test the hypothesis that the presence of myocardial ischemia with multi-vessel coronary stenosis is associated with better left ventricular function after primary coronary intervention in patients with acute ST-elevation myocardial infarction (STEMI ). Methods: Seventy sequential patients with first acute STEMI who were treated by primary coronary angioplasty were studied. Twenty patients had a single lesion-in the infarct related artery treated by primary angioplasty while 50 had multi-vessel coronary stenosis in addition to the infarct related artery treated by multiple angioplasties. Evaluation of pain-to balloon time, ST-elevation resolution, myocardial biomarker blood levels, left ventricular systolic function was performed. Results: Left ventricular ejection fraction in patient with single infarct related artery was 45.5±10 while in the multi-vessel disease 47.5±9%, p=ns. Significant differences in the other parameters were not found. Conclusions: Though multi-vessel coronary artery disease is expected to be associated with worse prognosis, in the setting of acute STEMI treated by primary coronary angioplasty, left ventricular systolic function was not different from those with single vessel disease.