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TUESDAY, Sept. 3, 2019 (HealthDay News) — For patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease, complete revascularization is superior to culprit lesion-only percutaneous coronary intervention (PCI), according to a study published online Sept. 1 in the New England Journal of Medicine<\/i>. The research was published to coincide with the European Society of Cardiology Congress 2019, held from Aug. 31 to Sept. 4 in Paris.<\/p>\n
Shamir R. Mehta, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues randomly assigned patients with STEMI and multivessel coronary artery disease who had undergone successful culprit-lesion PCI to either a strategy of complete revascularization with PCI of angiographically significant nonculprit lesions or no further revascularization. Patients were followed for a median of three years.<\/p>\n
The researchers found that the first coprimary outcome (composite of cardiovascular death or myocardial infarction) occurred in 7.8 and 10.5 percent of patients in the complete-revascularization and culprit lesion-only PCI groups, respectively (hazard ratio, 0.74). The second coprimary outcome (composite of cardiovascular death, myocardial infarction, or ischemia-driven revascularization) occurred in 8.9 and 16.7 percent of patients, respectively (hazard ratio, 0.51). Regardless of the intended timing of nonculprit-lesion PCI, the benefit of complete revascularization was seen consistently for both coprimary outcomes.<\/p>\n
“In light of the results of the well-planned and well-executed trial by Mehta et al., the guidelines should recommend a strategy of full revascularization in patients with STEMI and multivessel disease, at least in those who have suitable nonculprit lesions,” write the authors of an accompanying editorial.<\/p>\n
The study was partially funded by AstraZeneca and Boston Scientific.<\/p>\n
Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n Editorial (subscription or payment may be required)<\/a><\/p>\n