Randomized Trial of Complete vs. Culprit-Only PCI in STEMI

Complete revascularization during index hospitalization improved outcomes.

For patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, both the treatment of non–infarct-related arteries (IRA) and the timing of such treatment, if used, are controversial. In this multicenter, randomized trial, 146 patients in the U.K. presenting with STEMI received IRA-only percutaneous coronary intervention and were compared with 150 patients who underwent complete revascularization (including non-IRA) during either the initial procedure (in about two thirds) or before hospital discharge.

The primary composite endpoint of all-cause mortality, recurrent MI, heart failure, and ischemia-driven revascularization at 12 months was significantly lower with complete revascularization (10.0%) than with IRA-o…

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)