Left Anterior Descending Nonculprit Lesions and Clinical Outcomes in Patients With ST-Segment Elevation Myocardial Infarction
Authors' conclusion
Among patients presenting with STEMI and multivessel CAD, those with a proximal/mid-LAD NCL had similar event rates to those without. The benefit of complete revascularization between the groups was similar, with no evidence of heterogeneity.
Study context
- Population
- Patients with STEMI and multivessel disease1,666 with proximal/mid-LAD nonculprit lesion (NCL)
- Participants
- 4,041 patients
- Comparison
- Complete revascularization vs culprit-only PCI, by proximal/mid-LAD NCL location
- Proximal/mid-LAD NCLn = 1,666
- Primary endpoint
- Coprimary: (1) CV death or new MI; (2) CV death, new MI or ischemia-driven revascularization
Methodological detailscentral core laboratory angiography
- Central core laboratory angiography
Primary result
As reported in the abstract
CV death or new MI (first coprimary outcome)
Estimate (95% CI)
Proximal/mid-LAD NCLvs No proximal/mid-LAD NCL
adjusted HR 0.83(0.67–1.03)
Complete revascularizationvs Culprit-onlyproximal/mid-LAD NCL
HR 0.85(0.61–1.18)
Complete revascularizationvs Culprit-onlyno proximal/mid-LAD NCL
HR 0.65(0.50–0.86)
Original publication
Left Anterior Descending Nonculprit Lesions and Clinical Outcomes in Patients With ST-Segment Elevation Myocardial Infarction. JACC Cardiovasc Interv. Published 4 December 2024. doi:10.
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