ABSTRACT
Purpose@#The aim of this study was to examine whether gonadotropin-releasing hormone (GnRH) agonist treatment is effective in preserving final height in patients with central precocious puberty (CPP) or early puberty (EP). @*Methods@#The medical records of 40 patients with CPP and 206 patients with EP who completed GnRH agonist treatment following diagnosis were analyzed retrospectively. Height and height standard deviation (height SDS) scores based on bone age (BA) were measured and calculated at baseline, after treatment completion, and at final follow-up to compare changes within and between groups. Predicted adult height (PAH) was estimated by the height corresponding to height SDS for BA in girls at 18 years 11 months of age based on the growth chart. @*Results@#PAH at baseline did not differ significantly between the CPP group (153.67±4.95) and the EP group (154.77±3.72). In the CPP group, PAH significantly increased at treatment completion (156.01±4.61) and at final follow-up (158.52±6.04) compared to baseline. In the EP group, PAH significantly increased at treatment completion (157.7±3.60) and at final follow-up (159.31±4.26) compared to baseline. The increase in PAH at all timepoints compared to baseline did not significantly differ between the CPP and EP groups. @*Conclusion@#Both CPP and EP groups had significantly greater PAH after treatment, with no difference in the amount of increase between groups. These results show that GnRH agonist treatment can help increase final height even in patients diagnosed with EP after the age of 8 years.
ABSTRACT
Colorectal cancer has a high incidence and mortality worldwide, with Westernized lifestyles and diet being significant contributing factors. Vitamin D and calcium have been known to reduce the incidence of colorectal cancer by affecting cell differentiation, proliferation, and apoptosis. Despite observational studies which have suggested that a higher serum vitamin D level can lower the risk of colorectal cancer and improve survival rates, no large-scale randomized controlled trials to establish these benefits have been conducted to date. Calcium intake has also been found to have a beneficial role in reducing the incidence and improving survival rates of colorectal cancer in several observational studies. Moreover, intervention studies have proved its effect in preventing colorectal adenomas. However, there are few intervention studies that have identified the relationship of vitamin D and calcium with colon cancer. To elucidate the impact of vitamin D and calcium supplementation on colorectal cancer, well-designed and large-scale randomized controlled trials are necessary in the future.
ABSTRACT
Purpose@#This study aimed to investigate the impact of postoperative radiotherapy (PORT) in de novo metastatic breast cancer (dnMBC) patients undergoing planned primary tumor resection (PTR) and to identify the subgroup of patients who would most benefit from PORT. @*Materials and Methods@#This study enrolled 426 patients with dnMBC administered PTR alone or with PORT. The primary and secondary outcomes were overall and progression-free survival (OS and PFS), respectively. @*Results@#The median follow-up time was 53.7 months (range, 3.1 to 194.4). The 5-year OS and PFS rates were 73.2% and 32.0%, respectively. For OS, clinical T3/4 category, triple-negative breast cancer (TNBC), postoperative chemotherapy alone were significantly poor prognostic factors, and administration of PORT failed to show its significance. Regarding PFS, PORT was a favorable prognostic factor (hazard ratio, 0.64; 95% confidence interval, 0.50 to 0.82; p < 0.001), in addition to T1/2 category, ≤ 5 metastases, and non-TNBC. According to the multivariate analyses of OS in the PORT group, we divided the patients into three groups (group 1, T1/2 and non-TNBC [n=193]; group 2, T3/4 and non-TNBC [n=171]; and group 3, TNBC [n=49]), and evaluated the effect of PORT. Although PORT had no significance for OS in all subgroups, it was a significant factor for good prognosis regarding PFS in groups 1 and 2, not in group 3. @*Conclusion@#PORT was associated with a significantly better PFS in patients with dnMBC who underwent PTR. Patients with clinical T1/2 category and non-TNBC benefited most from PORT, while those with TNBC showed little benefit.
ABSTRACT
Despite the coronavirus disease 2019 (COVID-19) vaccination roll-out, variant-related outbreaks have occurred repeatedly in Korea. Although public hospitals played a major role in COVID-19 patients’ care, difficulty incorporating evolving COVID-19 treatment guidelines called for a clinical pathway (CP). Eighteen public hospitals volunteered, and a professional review board was created. CPs were formulated containing inclusion/exclusion criteria, application flow charts, and standardized order sets. After CP roll-out, key parameters improved, such as increased patient/staff five-point satisfaction scores (0.41/0.57) and decreased hospital stays (1.78 days)/medical expenses (17.5%). The CPs were updated consistently after roll-out as new therapeutics drugs were introduced and quarantine policies changed.
ABSTRACT
Background@#The association between serum cholesterol levels and depression has been studied extensively; however, results are inconsistent. This study aimed to investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and depressive symptoms among Korean adults. @*Methods@#This cross-sectional study used data obtained from the 2007–2015 Korea National Health and Nutrition Examination Survey. In total, 40,904 adults were included in the final analysis. Participants were categorized into five groups according to their LDL-C levels, using the Korean guidelines for dyslipidemia. Symptoms of depression were evaluated using a self-reported questionnaire. Weighted logistic regression was used to examine the relationship between LDL-C levels and self-reported depressive symptoms. @*Results@#Compared with the intermediate category, the lowest (<70 mg/dL) and highest (≥160 mg/dL) LDL-C categories were associated with depressive symptoms, after adjusting for potential confounding factors (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.008–1.409; OR, 1.241; 95% CI, 1.073–1.435, respectively). The highest LDL-C category was positively associated with depressive symptoms in those who were middle-aged, female, had a low body mass index, and taking or not taking dyslipidemia medications. @*Conclusion@#A U-shaped association was identified between LDL-C categories and self-reported depressive symptoms. Our findings suggest that LDL-C levels that are too low or too high are associated with self-reported depressive symptoms. Further prospective studies are needed to determine the causal relationship of this association.
ABSTRACT
Purpose@#To determine the effectiveness of salvage radiation therapy (RT) in patients with locoregional recurrence (LRR) following initial curative resection of non-small cell lung cancer (NSCLC) and identify the prognostic factors affecting survival. @*Materials and Methods@#Between January 2009 and January 2019, 54 patients with LRR after NSCLC surgery were treated with salvage RT (83.3%) or concurrent chemoradiation therapy (16.7%). Twenty-three (42.6%), 21 (38.9%), and 10 (18.5%) patients had local, regional, and both recurrences, respectively. The median RT dose was 66 Gy (range, 37.5 to 70 Gy). The radiation target volume included recurrent lesions with or without regional lymphatics depending on the location and recurrence type. @*Results@#The median follow-up time from the start of RT was 28.3 months (range, 2.4 to 112.4 months) and disease-free interval (DFI) from surgery to recurrence was 21.0 months (range, 0.5 to 92.3 months). Tumor response after RT was complete response, partial response, stable disease, and progressive disease in 17, 29, 5, and 3 patients, respectively. The rates of freedom from local progression at 1 and 2 years were 77.2% and 66.0%, respectively. The median survival duration after RT was 24.8 months, and the 2-year overall survival (OS) rate was 51.1%. On univariate analysis, initial stage, recurrence site, DFI, and tumor response after RT were significant prognostic factors for OS. DFI ≥12 months and tumor response after RT were statistically significant factors on multivariate Cox analysis for OS. @*Conclusion@#Our results demonstrated the effectiveness of salvage RT for LRR of NSCLC following curative surgery.
ABSTRACT
Purpose@#To determine the effectiveness of salvage radiation therapy (RT) in patients with locoregional recurrence (LRR) following initial curative resection of non-small cell lung cancer (NSCLC) and identify the prognostic factors affecting survival. @*Materials and Methods@#Between January 2009 and January 2019, 54 patients with LRR after NSCLC surgery were treated with salvage RT (83.3%) or concurrent chemoradiation therapy (16.7%). Twenty-three (42.6%), 21 (38.9%), and 10 (18.5%) patients had local, regional, and both recurrences, respectively. The median RT dose was 66 Gy (range, 37.5 to 70 Gy). The radiation target volume included recurrent lesions with or without regional lymphatics depending on the location and recurrence type. @*Results@#The median follow-up time from the start of RT was 28.3 months (range, 2.4 to 112.4 months) and disease-free interval (DFI) from surgery to recurrence was 21.0 months (range, 0.5 to 92.3 months). Tumor response after RT was complete response, partial response, stable disease, and progressive disease in 17, 29, 5, and 3 patients, respectively. The rates of freedom from local progression at 1 and 2 years were 77.2% and 66.0%, respectively. The median survival duration after RT was 24.8 months, and the 2-year overall survival (OS) rate was 51.1%. On univariate analysis, initial stage, recurrence site, DFI, and tumor response after RT were significant prognostic factors for OS. DFI ≥12 months and tumor response after RT were statistically significant factors on multivariate Cox analysis for OS. @*Conclusion@#Our results demonstrated the effectiveness of salvage RT for LRR of NSCLC following curative surgery.
ABSTRACT
Purpose@#To investigate the effect of lifestyle changes on patterns of carbon monoxide (CO) exposure and the association between neurologic symptoms and outcomes in Korean children with CO intoxication. @*Methods@#We reviewed the medical records of patients (< 18 years) with CO intoxication who visited the emergency department of Pusan National University Hospital between February 2012 and January 2020. We collected clinical findings, including age and sex, transfer from other hospitals, source, time and duration of exposure, manifestations with neurologic symptoms (syncope, seizure, and altered mental status), intensive care unit hospitalization, hospital length of stay, implementation of hyperbaric oxygen therapy, and findings of neuroimaging. These variables were compared between children with and without neurologic symptoms. In addition, levels of carboxyhemoglobin and lactate were compared between patients with and without specific manifestations. @*Results@#The enrolled 47 patients’ median age was 10 years (interquartile range, 4.5-14.0). The most common source of exposure was fire (46.8%), followed by camping (23.4%). The most common times of exposure were night (44.7%) and winter (44.7%). The patients with neurologic symptoms (14 [29.8%]) showed longer duration of exposure and hospital length of stay (P < 0.001 and P = 0.007, respectively). Of the 14 patients, 2 were hospitalized to the intensive care unit without an in-hospital mortality. A significant association was found between dyspnea and lactate level (P = 0.049), also between syncope or presyncope and carboxy hemoglobin level (P = 0.017). @*Conclusion@#CO intoxication in Korean children is most often caused by fire and camping, and at night and in winter. There is a correlation between neurologic symptoms and duration of exposure to CO.
ABSTRACT
Objective@#The emergency medical service (EMS) is expected to improve the prognosis of patients suffering from acutemyocardial infarction (AMI). We investigated the impact of utilizing EMS on the clinical outcomes of AMI patients. @*Methods@#From November 2011 to November 2015, a total of 13,102 patients in the Korea Acute Myocardial InfarctionRegistry-National Institute of Health (KAMIR-NIH) registry were enrolled. Patients were divided into two groups: the EMSgroup, first medical contact (FMC) with 119; the non-EMS group, the FMC at local hospitals that were not available forpercutaneous coronary intervention. The authors analyzed the mortality and major adverse cardiac and cerebrovascularevents during one-year of clinical follow-up. @*Results@#A total of 8,863 patients were finally analyzed for this study, and a total of 1,999 patients (22.6%) utilized theEMS as FMC. The patients utilizing EMS were more frequently diagnosed with ST-segment elevation AMI. At presentation,the EMS group had a higher incidence of Killip class IV, and they had a shorter symptom-to-door time than non-EMS group. The patients utilizing EMS had higher incidence of peri-procedural complications and in-hospital mortality.The multivariate logistic regression analysis with backward elimination revealed that utilizing EMS is an independent factorfor predicting lower one-year mortality. @*Conclusion@#This study has demonstrated that the high-risk AMI patients can utilize the EMS in Korea. The EMS grouphas more favorable clinical outcome during one-year follow-up after discharge than the non-EMS group, whereas it had ahigher rate of death during hospitalization compared with that of the non-EMS group.
ABSTRACT
BACKGROUND AND OBJECTIVES@#Although complete revascularization is known superior to incomplete revascularization in ST elevation myocardial infarction (STEMI) patients with multi-vessel coronary artery disease (MVCD), there are no definite instructions on the optimal timing of non-culprit lesions percutaneous coronary intervention (PCI). We compared 1-year clinical outcomes between 2 different complete multi-vessel revascularization strategies.@*METHODS@#From the Korea Acute Myocardial Infarction Registry-National Institute of Health, 606 patients with STEMI and MVCD who underwent complete revascularization were enrolled from November 2011 to December 2015. The patients were assigned to multi-vessel single-staged PCI (SS PCI) group (n=254) or multi-vessel multi-staged PCI (MS PCI) group (n=352). Propensity score matched 1-year clinical outcomes were compared between the groups.@*RESULTS@#At one year, MS PCI showed a significantly lower rate of all-cause mortality (hazard ratio [HR], 0.42; 95% confidential interval [CI], 0.19–0.92; p=0.030) compared with SS PCI. In subgroup analysis, all-cause mortality increased in SS PCI with cardiogenic shock (HR, 4.60; 95% CI, 1.54–13.77; p=0.006), age ≥65 years (HR, 4.00; 95% CI, 1.67–9.58, p=0.002), Killip class III/IV (HR, 7.32; 95% CI, 1.68–31.87; p=0.008), and creatinine clearance ≤60 mL/min (HR, 2.81; 95% CI, 1.10–7.18; p=0.031). After propensity score-matching, MS PCI showed a significantly lower risk of major adverse cardiovascular event than SS PCI.@*CONCLUSIONS@#SS PCI was associated with worse clinical outcomes compared with MS PCI. MS PCI for non-infarct-related artery could be a better option for patients with STEMI and MVCD, especially high-risk patients.
ABSTRACT
Metastatic skin cancers are a relatively uncommon malignant tumor. Visceral tumors such as breast, lung, and colon cancers are commonly found to be the primary origin. Cutaneous metastasis with esophageal cancer is exceedingly rare, accounting for less than one percent of all skin metastasis. Here, we report a case of cutaneous metastatic squamous cell carcinoma that originated from esophageal carcinoma. The patient was a 48-year-old male who complained of a 2-cm-sized non-tender, skin-colored nodule on his left lower back. Positron emission tomography-computed tomography (PET-CT) showed focal fluorodeoxyglucose (FDG) uptake in the lesion. In the histopathological examination, the tumor cells stained positive for epithelial membrane antigen (EMA) and cytokeratin 5/6 (CK5/6), which was consistent with squamous cell carcinoma. This case suggests that patients who have been treated for primary esophageal carcinoma should undergo a skin biopsy to rule out metastatic skin cancer if the tumor appears to be suspicious.
ABSTRACT
Background@#Alopecia areata is an autoimmune disease that presents as non-scarring hair loss and can affect all age groups. The clinical course of alopecia areata is unpredictable. @*Objective@#This study aimed to analyze the characteristics, treatment response, and relapse rate of alopecia areata in patients of different ages with long-term follow-up. @*Methods@#The medical records of 121 patients diagnosed with alopecia areata were retrospectively reviewed, and their prognosis was assessed on the basis of various indices. @*Results@#A total of 121 patients, including 24 cases of childhood-onset, 83 adult-onset, and 14 late-onset alopecia areata, were analyzed. In the first episode, 72.7%, 14.7%, and 9.9% of patients had mild, moderate, and severe alopecia areata, respectively. A significant and complete response was observed in 66.7%, 89.2%, and 100% of childhood-onset, adult-onset, and late-onset patients, respectively. The duration of the initial episode showed a negative correlation with age. The overall frequency of relapse was 47.1%, whichc significantly declined with time, with a majority (63.3%) of relapses occurring in the first year. Younger age at initial presentation and thyroid diseases were strongly associated with poor prognosis. @*Conclusion@#Younger patients showed a tendency of poor prognosis regardless of the prognostic factors. A longer follow-up period might be required for the younger onset patients.
ABSTRACT
Familial hypophosphatemic rickets (FHR) is a disorder characterized by phosphate wasting and hypophosphatemia due to defects in renal phosphate transport regulation. There are 4 known inherited forms of FHR that differ in their molecular causes. Very few studies have been conducted that focused on the molecular analysis of FHR in Koreans. Eighteen mutations of the PHEX gene have been identified to this date in Korea. Herein, we report the clinical case of a 24-month-old boy presenting with bowed legs and short stature. The biochemical profile showed hypophosphatemia with decreased tubular reabsorption of phosphate. Several family members were identified with short stature and genu varum. Therefore, he was diagnosed with FHR. To identify the molecular causes of FHR, we performed targeted gene panel sequencing and found a novel hemizygous missense variant, c.1949T>C (p.Leu650Pro), in the PHEX gene. This variant was also detected in the boy’s mother who exhibited genu varum and short stature.
ABSTRACT
Purpose@#We retrospectively evaluated the prognostic significance of lymph node ratio (LNR) in patients with esophageal squamous cell carcinoma who underwent neoadjuvant concurrent chemoradiation therapy (NCRT) followed by surgery. @*Materials and Methods@#In total, 270 patients who underwent NCRT followed by surgery between August 2005 and December 2015 were included. They were divided into three groups: LNR 0 (n = 196), LNR low (0 0.1; n = 11). The primary endpoint was overall survival (OS), and the secondary endpoints were freedom from local recurrence (FFLR), distant metastasis-free survival (DMFS), and disease-free survival (DFS). @*Results@#The median number of retrieved lymph nodes per patient was 33. Pathologically, 74 patients had positive lymph nodes. The median follow-up duration was 36.1 months, and the median survival period was 68.4 months. There was a significant correlation between LNR and the number of positive lymph nodes (correlation coefficient = 0.763, p < 0.001). There was a substantial difference in the OS among the LNR groups, with 2-year survival rates of 79.0%, 54.0%, and 9.1% in the LNR 0, LNR low, and LNR high groups, respectively (p < 0.001). A marked decrease in FFLP, DMFS, and DFS was observed with the increasing LNR. In subgroup analysis, the survival results of patients with clinically positive lymph node were similar from those of entire cohort. @*Conclusion@#LNR is a significant prognostic factor in patients with esophageal squamous cell carcinoma who underwent NCRT followed by surgery. Additional treatment and closer follow-up would be necessary for patients with a high LNR.
ABSTRACT
Purpose@#Trauma is the leading cause of death and disability in children. We aimed to compare the clinical characteristics of children with trauma and disease. @*Methods@#We reviewed the medical records of children (< 19 years) who visited the emergency department of Pusan National University Hospital from 2016 through 2018. Data on the age, age group, sex, details of trauma or disease, severe trauma or disease (Korean Triage Acuity Scale 1-2), hospitalization rate (overall and intensive care unit [ICU]), hospital length of stay, in-hospital mortality, and the Injury Severity Score were compared between the children with trauma and those with disease. @*Results@#In a total of 10,205 children, 3,028 (29.7%) had trauma. The children with trauma were older than those with disease (median age, 78.5 months [interquartile range, 35.0-165.0] vs. 49.0 [16.0-120.0]; P < 0.001). Boys were more common in the former group than the latter (63.7% vs. 56.3%; P < 0.001). The most common injury mechanism was traffic accident (16.0%), followed by fall and foreign body. The overall hospitalization rate was higher in the children with disease (17.1% vs. 35.9%; P < 0.001). However, the children with trauma underwent more frequent ICU hospitalization, and showed higher in-hospital mortality rate and longer hospital length of stay than those with disease (all P < 0.001). The children with severe trauma showed higher median age, percentage of boys, in-hospital mortality, and ICU hospitalization rate, and longer hospital length of stay than those with severe disease (all P < 0.001). @*Conclusion@#Children with trauma tend to be older, and their condition may be more critical in severity than those with disease. This difference is more prominent in those with severe trauma or disease.
ABSTRACT
Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made.
ABSTRACT
Purpose@#We retrospectively evaluated the prognostic significance of lymph node ratio (LNR) in patients with esophageal squamous cell carcinoma who underwent neoadjuvant concurrent chemoradiation therapy (NCRT) followed by surgery. @*Materials and Methods@#In total, 270 patients who underwent NCRT followed by surgery between August 2005 and December 2015 were included. They were divided into three groups: LNR 0 (n = 196), LNR low (0 0.1; n = 11). The primary endpoint was overall survival (OS), and the secondary endpoints were freedom from local recurrence (FFLR), distant metastasis-free survival (DMFS), and disease-free survival (DFS). @*Results@#The median number of retrieved lymph nodes per patient was 33. Pathologically, 74 patients had positive lymph nodes. The median follow-up duration was 36.1 months, and the median survival period was 68.4 months. There was a significant correlation between LNR and the number of positive lymph nodes (correlation coefficient = 0.763, p < 0.001). There was a substantial difference in the OS among the LNR groups, with 2-year survival rates of 79.0%, 54.0%, and 9.1% in the LNR 0, LNR low, and LNR high groups, respectively (p < 0.001). A marked decrease in FFLP, DMFS, and DFS was observed with the increasing LNR. In subgroup analysis, the survival results of patients with clinically positive lymph node were similar from those of entire cohort. @*Conclusion@#LNR is a significant prognostic factor in patients with esophageal squamous cell carcinoma who underwent NCRT followed by surgery. Additional treatment and closer follow-up would be necessary for patients with a high LNR.
ABSTRACT
Purpose@#Trauma is the leading cause of death and disability in children. We aimed to compare the clinical characteristics of children with trauma and disease. @*Methods@#We reviewed the medical records of children (< 19 years) who visited the emergency department of Pusan National University Hospital from 2016 through 2018. Data on the age, age group, sex, details of trauma or disease, severe trauma or disease (Korean Triage Acuity Scale 1-2), hospitalization rate (overall and intensive care unit [ICU]), hospital length of stay, in-hospital mortality, and the Injury Severity Score were compared between the children with trauma and those with disease. @*Results@#In a total of 10,205 children, 3,028 (29.7%) had trauma. The children with trauma were older than those with disease (median age, 78.5 months [interquartile range, 35.0-165.0] vs. 49.0 [16.0-120.0]; P < 0.001). Boys were more common in the former group than the latter (63.7% vs. 56.3%; P < 0.001). The most common injury mechanism was traffic accident (16.0%), followed by fall and foreign body. The overall hospitalization rate was higher in the children with disease (17.1% vs. 35.9%; P < 0.001). However, the children with trauma underwent more frequent ICU hospitalization, and showed higher in-hospital mortality rate and longer hospital length of stay than those with disease (all P < 0.001). The children with severe trauma showed higher median age, percentage of boys, in-hospital mortality, and ICU hospitalization rate, and longer hospital length of stay than those with severe disease (all P < 0.001). @*Conclusion@#Children with trauma tend to be older, and their condition may be more critical in severity than those with disease. This difference is more prominent in those with severe trauma or disease.
ABSTRACT
Diabetic radiculoneuropathy is an uncommon complication of diabetes mellitus that can affect the cervical, thoracic, or lumbosacral nerve roots. When the thoracic nerve roots are affected, it can cause truncal pain and, more rarely, abdominal bulging. A 62-year-old man with diabetes developed sudden pain in his right abdomen with subsequent distention overlying the area for 10 days. Neither vesicular eruptions nor cutaneous scarring was noted. Imaging scans of the abdomen and spinal cord did not reveal any other causes of abdominal distention. Needle electromyography showed evidence of radiculoneuropathy in the right thoracic regions (T6 through T9), and nerve conduction study of the upper and lower extremities also showed evidence suggestive of severe distal symmetric polyneuropathy. With the exclusion of any apparent causes of abdominal distention, a diagnosis of diabetic radiculoneuropathy was made.
ABSTRACT
BACKGROUND AND OBJECTIVES: Although complete revascularization is known superior to incomplete revascularization in ST elevation myocardial infarction (STEMI) patients with multi-vessel coronary artery disease (MVCD), there are no definite instructions on the optimal timing of non-culprit lesions percutaneous coronary intervention (PCI). We compared 1-year clinical outcomes between 2 different complete multi-vessel revascularization strategies.METHODS: From the Korea Acute Myocardial Infarction Registry-National Institute of Health, 606 patients with STEMI and MVCD who underwent complete revascularization were enrolled from November 2011 to December 2015. The patients were assigned to multi-vessel single-staged PCI (SS PCI) group (n=254) or multi-vessel multi-staged PCI (MS PCI) group (n=352). Propensity score matched 1-year clinical outcomes were compared between the groups.RESULTS: At one year, MS PCI showed a significantly lower rate of all-cause mortality (hazard ratio [HR], 0.42; 95% confidential interval [CI], 0.19–0.92; p=0.030) compared with SS PCI. In subgroup analysis, all-cause mortality increased in SS PCI with cardiogenic shock (HR, 4.60; 95% CI, 1.54–13.77; p=0.006), age ≥65 years (HR, 4.00; 95% CI, 1.67–9.58, p=0.002), Killip class III/IV (HR, 7.32; 95% CI, 1.68–31.87; p=0.008), and creatinine clearance ≤60 mL/min (HR, 2.81; 95% CI, 1.10–7.18; p=0.031). After propensity score-matching, MS PCI showed a significantly lower risk of major adverse cardiovascular event than SS PCI.CONCLUSIONS: SS PCI was associated with worse clinical outcomes compared with MS PCI. MS PCI for non-infarct-related artery could be a better option for patients with STEMI and MVCD, especially high-risk patients.