Coronary disease & ACSSecondary analysis
Complete revascularization according to age in patients with ST-segment elevation myocardial infarction and multivessel disease: 10-year outcome from the DANAMI-3–PRIMULTI trial
- long-term sub-study
- randomized
Authors' conclusion
In patients aged ≥75 years, clear evidence of a long-term (10 years) benefit of complete revascularization was not demonstrated. However, the elderly subgroup was small with limited events, and the finding should be interpreted as inconclusive. In contrast, complete revascularization was associated with a 32% lower risk of adverse outcomes among younger patients, primarily driven by a reduction in repeat revascularization, without evidence of reduced all-cause death or recurrent myocardial infarction.
Study context
- Population
- Patients with STEMI and multivessel disease, stratified by age <75 years and ≥75 years<75 years 517 · ≥75 years 110
- Participants
- 627 patients
- Comparison
- culprit-only or fractional flow reserve-guided complete revascularization
- Complete revascularization (older)n = 50
- Culprit-only (older)n = 60reference
- Complete revascularization (younger)n = 264
- Culprit-only (younger)n = 253reference
- Primary endpoint
- Composite of:
- All-cause mortality
- Recurrent myocardial infarction
- Any revascularization
- Follow-up
- Median 10.5 years
Primary result
As reported in the abstract
Adjusted hazard ratio (95% CI)P value
Complete revascularization (older) vs Culprit-only (older)older group (≥75 years)
1.29(0.82–2.03)
P = 0.27Complete revascularization (younger) vs Culprit-only (younger)younger patients
0.68(0.53–0.88)
P = 0.003Further findings
| Outcome | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Any revascularization (younger patients) | 0.60 (0.44–0.83) | P = 0.002 | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
Complete revascularization according to age in patients with ST-segment elevation myocardial infarction and multivessel disease: 10-year outcome from the DANAMI-3–PRIMULTI trial. Eur Heart J Acute Cardiovasc Care. Published 2 September 2026. doi:10.1093/ehjacc/zuag112
Summarised from the published abstract; every number is checked against it