Effects of complete revascularization according to age in patients with ST-segment elevation myocardial infarction and multivessel disease (COMPLETE-AGE)
Authors' conclusion
In patients with STEMI and multivessel CAD, complete revascularization compared with culprit-lesion-only PCI reduced major cardiovascular events regardless of patient age
Study context
- Population
- Patients with STEMI and multivessel disease, by age (≥65 vs <65 years)1,613 aged ≥65 years
- Participants
- 4,041 patients
- Comparison
- Staged complete revascularization vs culprit-lesion-only percutaneous coronary intervention (PCI), by age
- Primary endpoint
- Coprimary: CV death or new MI; CV death, new MI or ischemia-driven revascularization
- Follow-up
- Median 35.8 months
Methodological detailsprespecified subgroup analysis, multinational
- Prespecified subgroup analysis
- Multinational
Primary result
As reported in the abstract
CV death or new MI (first coprimary), by age
Complete revascularization vs Culprit-lesion-only PCIHazard ratio (95% CI)
≥65 years: 9.7% vs 12.5%
0.77(0.58–1.04)
<65 years: 6.7% vs 9.1%
0.72(0.54–0.96)
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| CV death, new MI or IDR (second coprimary), by ageComplete revascularizationvs Culprit-lesion-only PCI≥65 years | 0.56 (0.43–0.74) | |
| CV death, new MI or IDR (second coprimary), by ageComplete revascularizationvs Culprit-lesion-only PCI<65 years | 0.48 (0.37–0.61) | |
| Coprimary event rates, age ≥65 vs <65 years≥65 yearsvs <65 yearsCV death or new MI: 11.2% vs 7.9% | 1.49 (1.22–1.83) | |
| Coprimary event rates, age ≥65 vs <65 years≥65 yearsvs <65 yearsCV death, new MI or IDR: 14.4% vs 11.8% | 1.28 (1.07–1.52) | |
| 0.20.5125Hazard ratio (log scale) |
- Cardiovascular (CV) death, new myocardial infarction (MI) or ischemia-driven revascularization (IDR) (second coprimary), by age: interaction P = .37
Sensitivity analysis, 75-year threshold
- Consistent results (albeit attenuated)
Original publication
Effects of complete revascularization according to age in patients with ST-segment elevation myocardial infarction and multivessel disease (COMPLETE-AGE). Am Heart J. Published 21 October 2023. doi:10.
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