INTRODUCTION AND OBJECTIVES: Multivessel primary percutaneous coronary intervention (pPCI) is still often used in patients with ST-elevation myocardial infarction (STEMI) and cardiogenic shock (CS). The study aimed to compare the characteristics and prognosis of patients with CS-STEMI and multivessel coronary disease (MVD) treated with culprit vessel-only pPCI or multivessel-pPCI during the initial procedure. MATERIAL AND METHODS: From 2016 to 2020, 23,703 primary PCI patients with STEMI were included in a national all-comers registry of cardiovascular interventions. Of them, 1,213 (5.1%) patients had CS and MVD at admission to the hospital. Initially, 921 (75.9%) patients were treated with culprit vessel (CV)-pPCI and 292 (24.1%) with multivessel (MV)-pPCI. RESULTS: Patients with 3-vessel disease and left main disease had a higher probability of being treated with MV-pPCI than patients with 2-vessel disease and patients without left main disease (28.5% vs. 18.6%; p < 0.001 and 37.7% vs. 20.6%; p < 0.001). Intra-aortic balloon pump, extracorporeal membrane oxygenation (ECMO), and other mechanical circulatory support systems were more often used in patients with MV-pPCI. Thirty (30)-day and 1-year all-cause mortality rates were similar in the CV-pPCI and MV-pPCI groups (odds ratio, 1.01; 95% confidence interval [CI] 0.77 to 1.32; p = 0.937 and 1.1; 95% CI 0.84 to 1.44; p = 0.477). The presence of 3-vessel disease and the use of ECMO were the strongest adjusted predictors of 30-day and 1-year mortality. CONCLUSIONS: Our data from an extensive all-comers registry suggests that selective use of MV-pPCI does not increase the all-cause mortality rate in patients with CS-STEMI and MVD compared to CV-pPCI.

3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady Prague Czech Republic

Institute of Biostatistics and Analyses of Masaryk University Brno Czech Republic; Institute of Health Information and Statistics of the Czech Republic Czech Republic

Institute of Clinical and Experimental Medicine Prague Czech Republic

International Clinical Research Center and Department of Cardioangiology St Anne University Hospital and Masaryk University Brno Czech Republic

Masaryk Hospital Usti Nad Labem Czech Republic

Regional Hospital Karlovy Vary Czech Republic

Regional Hospital Pardubice Czech Republic

University Hospital and Faculty of Medicine Hradec Kralové Czech Republic

University Hospital and Faculty of Medicine Ostrava Czech Republic

University Hospital and Faculty of Medicine Pilsen Czech Republic

University Hospital Brno and Faculty of Medicine of Masaryk University Department of Internal Medicine and Cardiology Brno Czech Republic

University Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

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