Key result
Early angio-guided complete revascularization in STEMI with multivessel disease was associated with lower MACE-free survival compared to incomplete revascularization (57% vs 73.8%, P=0.05).
Why the study?
Does early angio-guided complete revascularization reduce major adverse cardiac events compared to ischemia-guided staged PCI in STEMI patients with multivessel disease?
Cohort (n=800)
Yes
Does early angio-guided complete revascularization reduce major adverse cardiac events compared to ischemia-guided staged PCI in STEMI patients with multivessel disease?
Absolute Event Rate: 57% vs 73.8%
p-value: p=0.05
In STEMI patients with multivessel disease, early angio-guided complete revascularization was associated with higher rates of periprocedural MI and MACE compared to an ischemia-guided staged approach.
No takes yet. Share an insight, caveat, or question.
Early angio-guided complete revascularization should not yet change practice in STEMI multivessel disease; leaves open whether ischemia-guided staging improves outcomes.
Meliga et al. (2011) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) with multivessel disease (n=800). Early-staged, angio-guided PCI of non-infarct-related arteries (complete revascularization) vs. Incomplete revascularization (delayed, ischemia-guided treatment) was evaluated on MACE-free survival (composite of death, MI, and repeat revascularization) (p=0.05). Early angio-guided complete revascularization in STEMI with multivessel disease was associated with lower MACE-free survival compared to incomplete revascularization (57% vs 73.8%, P=0.05).
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