Complete revascularization timing in ST-segment elevation myocardial infarction and multivessel disease with heart failure: the OPTION–STEMI trial
Authors' conclusion
In the OPTION-STEMI trial, among patients with STEMI and multi-vessel disease who were not in cardiogenic shock, immediate complete revascularization was not non-inferior compared with staged complete revascularization. However, subgroup analysis suggests that the worse outcomes with immediate complete revascularization may be limited to patients with heart failure at admission.
Study context
- Population
- Patients with STEMI and multivessel disease, with or without HF at admission (Killip class II or III)329 (33.1%) with HF
- Participants
- 994 patients
- Comparison
- Immediate vs staged complete revascularization, by HF at admission
- Primary endpoint
- Composite of:
- All-cause death
- Non-fatal MI
- Any unplanned revascularization
- Follow-up
- 1 year
Methodological detailspre-specified subgroup analysis
- Pre-specified subgroup analysis
Primary result
As reported in the abstract
Primary endpoint by HF status (subgroups)
Immediate vs StagedHazard ratio (95% CI)
HF at admission: 22.8% vs 13.3%
1.79(1.05–3.04)
No HF: 8.0% vs 9.5%
0.84(.50-1.40)
Further findings
| Outcome | HF | No HF | Adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Primary endpoint, HF vs no HF at admission | 18.2% | 8.7% | 1.63 (1.11–2.40) | P = 0.013 | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
Complete revascularization timing in ST-segment elevation myocardial infarction and multivessel disease with heart failure: the OPTION–STEMI trial. Eur Heart J. Published 6 January 2026. doi:10.
Summarised from the published abstract; every number is checked against it