{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:36:58Z","timestamp":1783985818237,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study aimed to investigate the relationship between a complex percutaneous coronary intervention (C-PCI) and long-term clinical outcomes in the AMI cohort. A total of 10,329 patients were categorized into the C-PCI and non-C-PCI groups. The primary ischemic endpoint was a composite of major adverse cardiac events (MACEs, cardiac death, myocardial infarction, stent thrombosis and revascularization). The primary bleeding endpoint was the risk of overt bleeding (BARC 2, 3 or 5). The median follow-up duration was 4.9 (2.97, 7.16) years. The risks of MACEs and bleeding were significantly higher in the C-PCI group (hazard ratio (HR): 1.72; 95% confidence interval (CI): 1.60 to 1.85; p &lt; 0.001; and HR: 1.32; 95% CI: 1.17 to 1.50; p &lt; 0.001, respectively). After propensity score matching, compared to the non-C-PCI group, the adjusted MACE rate in C-PCI remained significantly higher (p &lt; 0.001), but no significant interaction (p = 0.273) was observed for bleeding. Significant differences in overt bleeding were observed only within the first three months (p = 0.024). The MACEs were consistently higher in the C-PCI group with or without severe comorbid conditions (p &lt; 0.001 for both). Patients with AMI who undergo C-PCI experience worse long-term ischemic outcomes after successful PCI, regardless of the presence of severe comorbidities.<\/jats:p>","DOI":"10.3390\/jcm11164853","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T23:28:41Z","timestamp":1660865321000},"page":"4853","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Independent Clinical Impacts of Procedural Complexity on Ischemic and Bleeding Events in Patients with Acute Myocardial Infarction: Long-Term Clinical Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0480-1046","authenticated-orcid":false,"given":"Kwan Yong","family":"Lee","sequence":"first","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung-Hee","family":"Hwang","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4833-4440","authenticated-orcid":false,"given":"Sungmin","family":"Lim","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Uijeongbu St. Mary\u2019s Hospital, The Catholic University of Korea, Uijeonbu 11765, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Uijeongbu St. Mary\u2019s Hospital, The Catholic University of Korea, Uijeonbu 11765, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun-Ho","family":"Choo","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9996-2346","authenticated-orcid":false,"given":"Ik Jun","family":"Choi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Incheon St. Mary\u2019s Hospital, The Catholic University of Korea, Incheon 21431, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3056-8791","authenticated-orcid":false,"given":"Gyu Chul","family":"Oh","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2179-1767","authenticated-orcid":false,"given":"In-Ho","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyung Hee University Hospital, Seoul 05278, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5425-1102","authenticated-orcid":false,"given":"Ki Dong","family":"Yoo","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, St. Vincent\u2019s Hospital, The Catholic University of Korea, Suwon 16247, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wook Sung","family":"Chung","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youngkeun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju 61469, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung Ho","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju 61469, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyuk","family":"Chang","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Center, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1161\/CIRCULATIONAHA.116.022061","article-title":"Treatment of Higher-Risk Patients With an Indication for Revascularization: Evolution Within the Field of Contemporary Percutaneous Coronary Intervention","volume":"134","author":"Kirtane","year":"2016","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.ijcard.2018.03.103","article-title":"Impact of percutaneous coronary intervention extent, complexity and platelet reactivity on outcomes after drug-eluting 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