Dr. Aaron Kugelmass, chief of the Division of Cardiology at Baystate Medical Center, presented findings last week at the American College of Cardiology’s Scientific Sessions 2010, advancing the medical community’s understanding of the best treatment for ST-elevation myocardial infarction (STEMI), a common--and deadly--type of heart attack.
Dr. Kugelmass’s research found that a significant number of STEMI patients still receive angioplasty in multiple vessels of the heart, despite evidence that angioplasty in only the blocked vessel that is causing the heart attack is a superior course of treatment for those patients. Both the American College of Cardiology and the American Heart Association recommend angioplasty in just the blocked vessel.
According to Dr. Kugelmass’s research, STEMI patients undergoing multi-vessel angioplasty were more likely to be male, to experience cardiogenic shock and to have a drug-eluting stent. They also experience increased unadjusted in-hospital mortality and are more likely to experience acute renal failure.
The study compared the following clinical outcomes between patients undergoing single-vessel versus multi-vessel angioplasty:
- Acute renal failure
- New-onset hemodialysis
- Any vascular complication
- Observed mortality
- Expected mortality
- Stent type and usage
“The study supports the current recommendations that STEMI patients undergo culprit-vessel angioplasty only, however, prospective assessment of this question is needed to identify the best treatment strategy for patients with STEMI and multi-vessel coronary artery disease,” said April Simon, RN, MSN, president of Cardiac Data Solutions and one of the researchers.
The study was funded and conducted by Cardiac Data Solutions Inc., an Atlanta-based heart-care consulting and research firm. Dr. Kugelmass serves on the firm’s advisory board.
Other researchers included:
- Phillip P. Brown, cardiovascular surgeon (retired) and past chairman, Department of Surgery, Centennial Medical Center
- David J. Cohen, MD, interventional cardiologist and director, Cardiovascular Research, Mid America Heart Institute, St. Luke’s Hospital
- Matthew R. Reynolds, MD, electrophysiologist and director, Economics and Quality of Life Assessment Group, Harvard Clinical Research Institute
- Steven D. Culler, PhD, associate professor, Rollins School of Public Health, Emory University.
Baystate Medical Center is one of the Thomson Reuters Top 100 Cardiovascular Hospitals in the U.S., and Dr. Kugelmass and his colleagues in Baystate’s Heart and Vascular Program are finalizing plans for a new heart and vascular center, the centerpiece of Baystate’s $251 million Hospital of the Future project, now under construction.