Does index admission complete revascularization reduce the composite primary endpoint at 12 months in patients undergoing primary PCI for STEMI and multivessel disease compared to treating only the infarct-related artery?
In patients with STEMI and multivessel disease, complete revascularization during the index admission significantly reduces the 12-month composite primary endpoint compared to culprit-lesion-only PCI.
In patients presenting for P-PCI with multivessel disease, index admission complete revascularization significantly lowered the rate of the composite primary endpoint at 12 months compared with treating only the IRA. In such patients, inpatient total revascularization may be considered, but larger clinical trials are required to confirm this result and specifically address whether this strategy is associated with improved survival.
Gershlick et al. (Sun,) studied this question.