Coronary disease & ACSRandomised controlled trial
Immediate versus staged complete revascularisation during index admission in patients with ST-segment elevation myocardial infarction and multivessel disease (OPTION–STEMI): a multicentre, non-inferiority, open-label, randomised trial
- Randomised controlled trial
- open-label
- non-inferiority
- multicentre (14 hospitals, South Korea)
- blinded endpoint adjudication
- Enrolment Dec 30, 2019 – Jan 15, 2024
Authors' conclusion
Among patients with STEMI and multivessel disease, immediate complete revascularisation was not shown to be non-inferior to staged complete revascularisation during the index admission in terms of incidence of a composite of death from any cause, non-fatal myocardial infarction, or any unplanned revascularisation at 1 year.
Study context
- Population
- Patients aged ≥19 years with STEMI and multivessel disease after culprit-lesion percutaneous coronary intervention (PCI)
- Participants
- 994 patients
- Comparison
- Immediate vs staged complete revascularisation during index admission
- Immediaten = 498
- Stagedn = 496reference
- Primary endpoint
- Death from any cause, non-fatal MI or any unplanned revascularisation
- Follow-up
- 1 year
Primary result
As reported in the abstract
Hazard ratio
1.24
95% CI 0.86–1.79
P = 0.24 for non-inferiority
Events by treatment group
Immediate vs Staged
HR 1.24 (95% CI 0.86–1.79); P for non-inferiority = 0.24
Safety
Cardiogenic shock during index hospitalisation
Stroke, major bleeding, contrast-induced nephropathy
- Did not differ significantly between groups
Original publication
Immediate versus staged complete revascularisation during index admission in patients with ST-segment elevation myocardial infarction and multivessel disease (OPTION–STEMI): a multicentre, non-inferiority, open-label, randomised trial. Lancet. Published 31 August 2025. doi:10.1016/s0140-6736(25)01529-6
Summarised from the published abstract; every number is checked against it