Randomised controlled trial
Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial
- Randomised controlled trial
- prospective
- open-label
- non-inferiority
- multicentre (29 hospitals)
Authors' conclusion
In patients presenting with acute coronary syndrome and multivessel disease, immediate complete revascularisation was non-inferior to staged complete revascularisation for the primary composite outcome and was associated with a reduction in myocardial infarction and unplanned ischaemia-driven revascularisation.
Study context
- Population
- Patients aged 18–85 years with STEMI or NSTE-ACS and multivessel CAD with a clearly identifiable culprit lesion, Belgium, Italy, the Netherlands and SpainITT population
- Participants
- 764 vs 761
- Comparison
- Immediate vs staged complete revascularisation
- Immediaten = 764
- Stagedn = 761reference
- Primary endpoint
- Composite of:
- All-cause mortality
- MI
- Any unplanned ischaemia-driven revascularisation
- Cerebrovascular events
- Follow-up
- 1 year after the index procedure
Primary result
As reported in the abstract
1 year
Hazard ratio
0.78
95% CI 0.55–1.11
P = 0.0011 for non-inferiority
Events by treatment group
Immediate vs Staged
HR 0.78 (95% CI 0.55–1.11); P for non-inferiority = 0.0011
Secondary outcomes
| Outcome | Immediate | Staged | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| All-cause death · 1 year | 1.9% | 1.2% | 1.56 (0.68–3.61) | P = 0.30 | |
| MI · 1 year | 1.9% | 4.5% | 0.41 (0.22–0.76) | P = 0.0045 | |
| Unplanned ischaemia-driven revascularisation · 1 year | 4.2% | 6.7% | 0.61 (0.39–0.95) | P = 0.030 | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial. Lancet. Published 5 March 2023. doi:10.1016/s0140-6736(23)00351-3
Summarised from the published abstract; every number is checked against it