Key result
Staged PCI linked to ~36% less cardiac death or MI vs one-time PCI in elderly NSTE-ACS.
Why the study?
Does staged PCI reduce the composite of cardiac death or MI in elderly patients with NSTE-ACS and multivessel disease compared to "one-time" multivessel PCI?
Cohort (n=1,090)
No
Does staged PCI reduce the composite of cardiac death or MI in elderly patients with NSTE-ACS and multivessel disease compared to "one-time" multivessel PCI?
Effect estimate: HR 0.638 (95% CI 0.408-0.998)
Absolute Event Rate: 7% vs 9.5%
p-value: p=0.049
In elderly patients with NSTE-ACS and multivessel disease, a staged PCI strategy may reduce the long-term risk of cardiac death or MI compared to a 'one-time' multivessel PCI approach.
May support staged PCI to lower cardiac death or MI risk in this population; leaves open need for randomized confirmation.
OBJECTIVE: To evaluate the clinical outcomes of "one-time" versus staged multivessel stenting in elderly (≥ 60 years) patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD). METHODS: = 467) according to intervention strategy. The primary endpoint was composite outcome of myocardial infarction (MI) or cardiac death during 3-year follow-up. RESULTS: = 0.746). CONCLUSIONS: In elderly NSTE-ACS patients with MVD, staged PCI might be an optimal strategy associated with reduced long-term cardiac death or MI compared with "one-time" PCI strategy, which needs further confirmation.
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Yu et al. (2016) conducted a cohort in Non-ST-elevation acute coronary syndrome (NSTE-ACS) with multivessel disease (n=1,090). Staged multivessel percutaneous coronary intervention (PCI) vs. "One-time" multivessel PCI was evaluated on Composite of cardiac death or myocardial infarction (MI) (HR 0.638, 95% CI 0.408-0.998, p=0.049). In elderly patients with non-ST-elevation acute coronary syndrome and multivessel disease, staged percutaneous coronary intervention reduced the 3-year risk of cardiac death or myocardial infarction compared to one-time intervention (HR 0.638).
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