Immediate Complete Revascularization During Index Admission in Older Patients With ST-Segment Elevation Myocardial Infarction
Authors' conclusion
This post hoc analysis of the OPTION-STEMI trial demonstrates that older patients experience significantly worse clinical outcomes with immediate CR than with in-hospital staged CR. These findings suggest that age modifies the treatment effect of the CR strategy and warrant confirmation in adequately powered trials (Timing of FFR-guided PCI for Non-IRA in STEMI and MVD [OPTION-STEMI]; NCT04626882).
Study context
- Population
- Patients with ST-segment elevation myocardial infarction and multivessel disease, analyzed according to agepatients randomized to immediate or in-hospital staged complete revascularization (CR)
- Participants
- 994 patients
- Comparison
- Immediate CR vs in-hospital staged CR, according to age
- Primary endpoint
- Composite of:
- All-cause death
- Nonfatal myocardial infarction
- Any unplanned revascularization
- Follow-up
- 1 year
Methodological detailspost hoc analysis, randomized to immediate or in-hospital staged CR
- Post hoc analysis
- Randomized to immediate or in-hospital staged CR
Primary result
As reported in the abstract
Immediate CR vs Staged CRHazard ratio (95% CI)P value
Patients ≥70 years
1.68(1.06–2.69)
log-rank P = 0.029Patients <70 years
0.80(0.45–1.45)
log-rank P = 0.470Original publication
Immediate Complete Revascularization During Index Admission in Older Patients With ST-Segment Elevation Myocardial Infarction. JACC Cardiovasc Interv. Published 22 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it