{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T15:54:20Z","timestamp":1757778860701,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>The clinical effects of multivessel interventions in patients with unstable angina\/non\u2010ST\u2010segment elevation myocardial infarction (UA\/NSTEMI), multivessel disease (MVD) and chronic kidney disease (CKD) remain uncertain. This study aimed to investigate the safety and effectiveness of intervention in non\u2010culprit lession(s) among this cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We consecutively included patients diagnosed with UA\/NSTEMI, MVD and CKD between January 2008 and December 2018 at our centre. After successful percutaneous coronary intervention (PCI), we compared 48\u2010month overall mortality between those undergoing multivessel PCI (MV\u2010PCI) through a single\u2010procedure or staged\u2010procedure approach and culprit vessel\u2010only PCI (CV\u2010PCI) after 1:1 propensity score matching. We conducted stratified analyses and tests for interaction to investigate the modifying effects of critical covariates. Additionally, we recorded the incidence of contrast\u2010induced nephropathy (CIN) to assess the perioperative safety of the two treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 749 eligible patients, 271 pairs were successfully matched. Those undergoing MV\u2010PCI had reduced all\u2010cause mortality (hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.48\u20130.67). Subgroup analysis showed that those with advanced CKD (estimated glomerular filtration rate (eGFR) \u2264\u200930 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>) could not benefit from MV\u2010PCI (<jats:italic>P<\/jats:italic> =\u20090.250), and the survival advantage also tended to diminish in diabetes (<jats:italic>P<\/jats:italic> <jats:sub>interaction<\/jats:sub> &lt;\u20090.01; HR\u2009=\u20090.95, 95% CI\u2009=\u20090.65\u20131.45). Although the staged\u2010procedure approach (<jats:italic>N<\/jats:italic> =\u2009157) failed to bring additional survival benefits compared to single\u2010procedure MV\u2010PCI (<jats:italic>N<\/jats:italic> =\u2009290) (<jats:italic>P<\/jats:italic> =\u20090.460), it showed a tendency to decrease the death risk. CIN risks in MV\u2010PCI and CV\u2010PCI groups were not significantly different (risk ratio\u2009=\u20091.60, 95% CI\u2009=\u20090.94\u20132.73).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among patients with UA\/NSTEMI and non\u2010diabetic CKD and an eGFR &gt;\u200930 mL\/min\/1.73 m<jats:sup>2<\/jats:sup>, MV\u2010PCI was associated with a reduced risk of long\u2010term death but did not increase the incidence of CIN during the management of MVD compared to CV\u2010PCI. And staged procedures might be a preferable option over single\u2010procedure MV\u2010PCI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16201","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T17:04:24Z","timestamp":1691514264000},"page":"473-482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The management of non\u2010culprit vessel(s) in patients with unstable angina\/<scp>non\u2010ST<\/scp> elevation myocardial infarction and chronic kidney dysfunction"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8309-744X","authenticated-orcid":false,"given":"Guang\u2010zhi","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Cardiology, West China Hospital Sichuan University  Chengdu 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