Journal of Yeungnam Medical Science

Original article

Complete or incomplete revascularization in patients with left main culprit lesion acute myocardial infarction with multivessel disease: a retrospective observational study: Sun Oh Kim, Hong-Ju Kim, Jong-Il Park, Kang-Un Choi, Jong-Ho Nam, Chan-Hee Lee, Jang-Won Son, Jong-Seon Park, Sung-Ho Her, Ki-Yuk Chang, Tae-Hoon Ahn, Myung-Ho Jeong, Seung-Woon Rha, Hyo-Soo Kim, Hyeon-Cheol Gwon, In-Whan Seong, Kyung-Kuk Hwang, Seung-Ho Hur, Kwang-Soo Cha, Seok-Kyu Oh, Jei-Keon Chae, Ung Kim; J Yeungnam Med Sci. 2025;42:18. Published online December 19, 2024; DOI: https://doi.org/10.12701/jyms.2025.42.18 [Epub ahead of print]

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Abstract PDF: Background
Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.
Methods
We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year.
Results
After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different.
Conclusion
There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Case Report

Enoxaparin Induced Fatal Retroperitoneal Hematoma in Elderly Patient with Acute Coronary Syndrome －Case Report－: Sang-Hee Lee, Jong-Seon Park, Woong Kim, Geu-Ru Hong, Dong-Gu Shin, Young-Jo Kim, Bong-Sub Shim; Yeungnam Univ J Med. 2007;24(2 Suppl):S642-646. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S642

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Anticoagulation and antiplatelet therapy became a cornerstone of the primary treatment strategy in the case of acute coronary syndrome patients which planned to receive medical treatment or percutaneous coronary intervention. The anticoagulation regimen is unfractionated heparins and low molecular weight heparins enoxaparin. Despite of some debates, enoxaparin has replaced unfractionated heparins recently due to its demonstrated advantages. When we encountered acute coronary syndrome patients without contraindication for enoxaparin, it tends to be administered with no hesitation. However, a few patients treated with enoxaparin could be suffered from bleeding complication. Also, in case of bleeding into the retroperitoneal space, the result can be fatal. We report a patient who developed a fatal retroperitoneal hematoma during enoxaparin treatment for acute coronary syndrome.

Citations

Citations to this article as recorded by

Enoxaparin-induced spontaneous massive retroperitoneal hematoma with fatal outcome
Nikolaos S. Salemis, Ioannis Oikonomakis, Emanuel Lagoudianakis, Georgios Boubousis, Christos Tsakalakis, Sotirios Sourlas, Stavros Gourgiotis
The American Journal of Emergency Medicine.2014; 32(12): 1559.e1. CrossRef

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