Complete Revascularization Beats Culprit-Lesion–Only in Older Patients with Myocardial Infarction

A lower rate of adverse cardiovascular events was demonstrated with physiology-guided complete revascularization at 1 year postprocedure.

Complete revascularization is supported for patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease based on trials in younger adults, but studies specific to older adults are lacking. In this large, randomized, multicenter European trial (NCT03772743), investigators compared the efficacy of complete versus culprit-lesion–only revascularization during the index hospitalization in 1445 patients aged ≥75 years (median age, 80 years). Participants had STEMI (35%) or non-STEMI and multivessel disease. Importantly, physiology guidance was utilized to identify functionally significant lesions.

Results were as follows:

The primary composite endpoint of death, MI, stroke, or repeat revascularization wi…

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)