Immediate multivessel PCI as effective as staged multivessel PCI for reducing risk of mortality, stroke or MI
A percutaneous coronary intervention (PCI) is a minimally invasive procedure widely used to open blocked coronary arteries. In patients with ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease, is a rising concern as the time at which complete revascularization of nonculprit lesions should be performed remains unknown.
Study in The New England Journal of Medicine, reveals that immediate PCI among patients in hemodynamically stable condition with STEMI and multivessel coronary artery disease, was non inferior to staged multivessel PCI with respect to the risk of death from any cause, nonfatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year.
An international, open-label, randomized, noninferiority trial was conducted by researchers at 37 sites in Europe. Patients in a hemodynamically stable condition who had STEMI and multivessel coronary artery disease were randomly assigned to undergo immediate multivessel percutaneous coronary intervention (PCI; immediate group) or PCI of the culprit lesion followed by staged multivessel PCI of nonculprit lesions within 19 to 45 days after the index procedure (staged group). The primary end point was a composite of death from any cause, nonfatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year after randomization. The percentages of patients with a primary or secondary end-point event are provided as Kaplan–Meier estimates at 6 months and at 1 year.
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