PCI in Non–Infarct-Related Arteries Improves Outcomes in Patients with ST-Segment-Elevation Myocardial Infarction

Restricting revascularization to culprit lesions during primary PCI led to a significantly higher rate of cardiac death, nonfatal MI, or refractory angina.

What to do about major coronary stenoses in arteries other than the infarct-related one is a frequent clinical conundrum during percutaneous coronary intervention (PCI). In this single-blind, multicenter study from the U.K., 465 patients with ST-segment-elevation myocardial infarction (STEMI) and multivessel coronary artery disease were randomly assigned to undergo infarct-artery–only PCI or additional PCI in non-infarct arteries during the initial procedure, a strategy the authors termed “preventative PCI.” Of note, patients with cardiogenic shock, prior coronary artery bypass grafting, significant left main disease, or chronically occluded arteries were excluded. Ischemia testing was discouraged in the trial and staged or delayed PCI was …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)