Coronary disease & ACSCohort study
Revascularization Strategies in ST-Segment Elevation Myocardial Infarction With Multivessel Disease
- Registry-based cohort study
- SWEDEHEART registry
- nationwide
Authors' conclusion
In patients with STEMI and MVD, the implementation of CR and physiology-guided procedures increased over time. As of 2021, 51% of patients underwent CR and 14% physiology-guided CR. CR, whether angiographically or physiology guided, was independently associated with favorable outcomes, including mortality.
Study context
- Population
- Patients undergoing primary PCI for STEMI with multivessel disease, SWEDEHEART registry, 2009–2021
- Participants
- 20,131 patients
- Exposure
- Complete revascularization vs incomplete revascularization
- Outcome
- Composite of:
- All-cause mortality
- MI or unplanned revascularization
- Landmarked at 90 days postindex
- Follow-up
- Median 4.2 years (Q1-Q3: 1.8-7.1 years)
Main finding
As reported in the abstract
Adjusted hazard ratio (95% CI)
Angiographic CR vs IR
0.84(0.79–0.89)
Physiology-guided CR vs IR
0.80(0.69–0.93)
Physiology-guided CR vs Angiographic CR
0.94(0.80–1.11)
Observational data: associations, not effects.
Further findings
Use of complete revascularization (CR) over time
- 2009
- 33% [n = 397 of 1,217]
- 2015
- 46% [n = 767 of 1,658]
- 2021
- 51% [n = 816 of 1,603]
- P-trend < 0.001
Use of physiology-guided CR over time
- 2009
- 0% [n = 0 of 1,217]
- 2015
- 7% [n = 119 of 1,658]
- 2021
- 14% [n = 218 of 1,603]
- P-trend < 0.001
Original publication
Revascularization Strategies in ST-Segment Elevation Myocardial Infarction With Multivessel Disease. JACC Cardiovasc Interv. Published 26 May 2025. doi:10.1016/j.jcin.2025.02.017
Summarised from the published abstract; every number is checked against it