Coronary disease & ACS

Impact of Revascularization Completeness on Cardiovascular Outcomes in STEMI With Multivessel Disease

Circ Cardiovasc IntervPublished exploratory post hoc analysis of the COMPLETE trial

Authors' conclusion

This exploratory analysis of the COMPLETE trial suggests that the benefit of a complete revascularization strategy in patients with ST-segment-elevation myocardial infarction and multivessel disease may be related to the extent of anatomic completeness of revascularization.

Study context

Population
Patients with ST-segment-elevation myocardial infarction and multivessel diseaseCOMPLETE trial
Participants
3,738 patients
Comparison
Degree of anatomic completeness of revascularization (R′SS=0 or R′SS>0) vs culprit-only percutaneous coronary intervention (PCI) arm as reference
Primary endpoint
First coprimary outcome: composite of cardiovascular death or new myocardial infarction
Methodological detailssubstudy of the COMPLETE trial, stratified Cox proportional hazards model, core laboratory-derived modified residual SYNTAX score (R′SS)
  • Substudy of the COMPLETE trial
  • Stratified Cox proportional hazards model
  • Core laboratory-derived modified residual SYNTAX score (R′SS)

Primary result

As reported in the abstract

First coprimary outcome: composite of cardiovascular death or new myocardial infarction
Each group vs culprit lesion-only PCIAdjusted hazard ratio (95% CI)
R′SS=0
0.61(0.47–0.78)
R′SS>0
1.01(0.61–1.67)

Further findings

OutcomeR′SS=0R′SS>0Culprit lesion-only PCI
Revascularization completeness among patients randomized to complete revascularization90%10%Not reported in the abstractculprit lesion-only PCI: not reported in the abstract

Second coprimary outcome: composite of cardiovascular death, new myocardial infarction, or ischemia-driven revascularization

A similar result was observed for the second coprimary outcome

Original publication

Impact of Revascularization Completeness on Cardiovascular Outcomes in STEMI With Multivessel Disease. Circ Cardiovasc Interv. Published 3 June 2026. doi:10.1161/circinterventions.126.016515

Summarised from the published abstract; every number is checked against it

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