Coronary disease & ACSRandomised controlled trial
Timing of Complete Revascularization with Multivessel Percutaneous Coronary Intervention (PCI) for Myocardial Infarction
- Randomised controlled trial
- international
- open-label
- noninferiority
- 37 sites in Europe
Authors' conclusion
Among patients in hemodynamically stable condition with STEMI and multivessel coronary artery disease, immediate multivessel PCI was noninferior to staged multivessel PCI with respect to the risk of death from any cause, nonfatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year.
Study context
- Population
- Hemodynamically stable patients with STEMI and multivessel CAD
- Participants
- 418 vs 422
- Comparison
- Immediate multivessel PCI vs staged multivessel PCI
- Immediaten = 418
- Stagedn = 422reference
- Primary endpoint
- Composite of:
- All-cause death
- Nonfatal MI
- Stroke
- Unplanned ischemia-driven revascularization
- Hospitalization for HF
- Follow-up
- 1 year after randomization
Primary result
As reported in the abstract
1 year
Risk ratio
0.52
95% CI 0.38–0.72
P < 0.001
Events by treatment group
Immediate vs Staged
risk ratio 0.52 (95% CI 0.38–0.72); P < 0.001
Secondary outcomes
Nonfatal MI
Unplanned ischemia-driven revascularization
All-cause death, stroke, hospitalization for HF
- Risk appeared similar in the two groups
Safety
events
| Outcome | Immediate | Staged |
|---|---|---|
| Serious adverse event | 104 | 145 |
Original publication
Timing of Complete Revascularization with Multivessel PCI for Myocardial Infarction. N Engl J Med. Published 27 August 2023. doi:10.1056/nejmoa2307823
Summarised from the published abstract; every number is checked against it