Should Non–Infarct-Related Coronary Arteries Also Be Revascularized After STEMI?

Complete multivessel revascularization, guided by fractional flow reserve, significantly improved 1-year revascularization rates, but not other 1-year clinical outcomes, in patients with ST-segment elevation myocardial infarction.

Should patients with ST-segment elevation myocardial infarction (STEMI) undergo percutaneous coronary intervention (PCI) in both infarct-related and non–infarct-related coronary arteries? Researchers in Europe and Asia randomized 885 patients with STEMI and multivessel disease who had undergone primary PCI of an infarct-related artery to undergo, in a 1:2 ratio, either complete staged revascularization of non–infarct-related arteries, guided by fractional flow reserve (FFR), or no revascularization of non–infarct-related arteries. (FFR was also measured in the infarct-artery-only group, but their procedures were stopped after FFR measurement.) Two FFR wire manufacturers funded the study.

At 1 year, incidence of the primary endpoint — all-cau…

Reviewing Author

Pascal Meier, MD

Disclosures

Editorial BoardsOpen Heart

Leadership Positions in Professional SocietiesEuropean Society of Cardiology (Communication Committee); European Association of Percutaneous Cardiovascular Interventions (Chair, Web & Communication Committee)

Pascal Meier, MD

Disclosures

Editorial BoardsOpen Heart

Should Non–Infarct-Related Coronary Arteries Also Be Revascularized After STEMI?

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Reviewing Author