Introduction: To the best of the authors' knowledge, very few publications are available
which report on the prognostic significance of the culprit vessel in patients with
ST elevation myocardial infarction treated with successful primary percutaneous coronary
intervention. Aim: The aim of the authors was to obtain data on the significance of
the culprit vessel in patients with ST elevation myocardial infarction treated successfully
by primary percutaneous coronary intervention. Method: The authors performed a retrospective
study in 10,763 patients with ST elevation myocardial infarction who underwent successful
primary percutaneous coronary intervention. The culprit vessels were the left main
artery, left anterior descendent artery, left circumflex artery, and right coronary
artery. The authors constructed univariate survival curves for different culprit vessels
and also performed multivariate modelling of time-to-death, controlling for age, sex,
and comorbidities. Results: The majority of the culprit lesions were found in the
left anterior descendent artery (44.3%), the right coronary artery (40.9%), and the
left circumflex artery (13.7%). The culprit vessel was overall a highly significant
(p<0.0001) factor of survival, with right coronary artery exhibiting a highly significantly
better prognosis (hazard ratio 0.69, 95% CI 0.61-0.79, p<0.0001) and left main artery
exhibiting a significantly worse prognosis (hazard ratio 1.56, 95% CI 1.04-2.35, p
= 0.0321) than the reference vessel (left anterior descendent artery). Conclusion:
These data demonstrate that the culprit vessel has independent prognostic significance.