Complete revascularization with multivessel PCI for myocardial infarction
New England Journal of Medicine Oct 16, 2019
Mehta SR, Wood DA, Storey RF, et al. - Individuals with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease who underwent successful culprit-lesion percutaneous coronary intervention (PCI) were randomized to an approach of either complete revascularization with PCI of angiographically important nonculprit lesions or no further revascularization in order to determine whether PCI of nonculprit lesions further decreased the risk of such events (for eg, cardiovascular death or myocardial infarction). For both co-primary outcomes, independent of the proposed timing of nonculprit-lesion PCI, the advantage of comprehensive revascularization was consistently noted. Thus, among individuals with STEMI and multivessel coronary artery disease, in decreasing the risk of cardiovascular death or myocardial infarction, as well as the risk of cardiovascular death, myocardial infarction, or ischemia-driven revascularization, complete revascularization was found out to be better than culprit-lesion-only PCI.
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