Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease

Gershlick, Anthony; Banning, Amerjeet; Parker, Emma; Wang, Duolao; Budgeon, Charley; Kelly, Damian J.; Kane, Peter O.; Dalby, Miles; Hetherington, Simon; McCann, Gerry P; Greenwood, John P.; Curzen, Nick

doi:10.1016/j.jacc.2019.10.033

Cited by 45 publications

(27 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, no difference was reported between groups in the safety endpoints of major bleeding, contrast-induced nephropathy, or stroke. The initial benefit of CR over COR was sustained at a median follow-up time of 5.6 years [21]. However, beyond 12 months, no significant difference between major cardiac adverse event, death/myocardial infarction, and individual components of the primary endpoint was observed.…”

Section: Complete Revascularizationmentioning

confidence: 91%

Complete Revascularization in Patients With STEMI and Multivessel Coronary Artery Disease: Is It Beneficial?

Voudris

Feldman

2021

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

Purpose of review Multivessel coronary artery disease is usually present in up to 50% of patients presenting with ST-elevation myocardial infarction (STEMI). The optimal revascularization approach for non-infarct related lesions has been a topic of recent debate. Various observational studies and clinical trials have been conducted to assess the impact of multivessel revascularization. In this review, we aim to present the currently available evidence behind the different revascularization strategies. Recent findings Early observational studies, registry-based analyses, and meta-analyses had suggested a benefit of culprit only revascularization over complete revascularization. However, in several recent randomized clinical trials, a complete revascularization approach for non-infarct-related lesions, either during the index hospitalization or as a staged approach, has been associated with improved outcomes. These findings exclude patients with cardiogenic shock and chronic total occlusions. Summary Clinical decisions regarding the extent and timing of revascularization in STEMI patients necessitate an individualized, patient-oriented approach. Based on the evidence from recent clinical trials, complete revascularization of non-culprit lesions in STEMI should be considered.

show abstract

Section: Complete Revascularizationmentioning

confidence: 91%

Complete Revascularization in Patients With STEMI and Multivessel Coronary Artery Disease: Is It Beneficial?

Voudris

Feldman

2021

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

show abstract

“…J o u r n a l P r e -p r o o f INTRODUCTION Multivessel coronary artery disease (MVD) is common in patients with ST-segment-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) 1 and is associated with worse outcomes compared with single-vessel coronary artery disease 1,2 . Complete multivessel revascularization by PCI provides superior long-term clinical outcomes compared to culprit lesion-only PCI in patients with STEMI and MVD 3,4 .…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Multivessel percutaneous coronary intervention with thin-strut biodegradable versus durable polymer drug-eluting stents in ST-segment elevation myocardial infarction: A subgroup analysis of the BIOSTEMI randomized trial

Iglesias

Müller

Losdat

et al. 2021

International Journal of Cardiology

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…59 After 5 years' follow-up, the long-term results of the CvLPRITwas recently published and showed that the risk of major adverse cardiovascular events was still significantly lower in the complete revascularization group compared with patients who had PCI of the culprit lesion-only. 60 The DANAMI-3 PRIMULTI (The Third DANish Study of Optimal Acute Treatment of Patients With STEMI: PRImary PCI in MULTIvessel Disease) randomly assigned 627 patients with one or more significant coronary stenosis in addition to the culprit lesion to either guideline-directed medical therapy or complete fractional flow reserve (FFR)-guided revascularization before discharge. The primary composite endpoint (all-cause mortality, nonfatal infarction, and ischemia-driven revascularization of lesions in noninfarct-related arteries) was significantly lower in the group with complete revascularization (13% vs. 22%; HR, 0.56; 95% CI, 0.38-0.83).…”

Section: Multivessel Coronary Artery Diseasementioning

confidence: 99%

Management of ST-Elevation Myocardial Infarction in High-Risk Settings

et al. 2021

View full text Add to dashboard Cite

Despite the widespread adoption of primary percutaneous intervention and modern antithrombotic therapy, ST-segment elevation myocardial infarction (STEMI) remains the leading cause of death in the United States and remains one of the most important causes of morbidity and mortality worldwide. Certain high-risk patients present a challenge for diagnosis and treatment. The widespread adoption of primary percutaneous intervention in addition to modern antithrombotic therapy has resulted in substantial improvement in the short- and long-term prognosis following STEMI. In this review, we aim to provide a brief analysis of the state-of-the-art treatment for patients presenting with STEMI, focusing on cardiogenic shock, current treatment and controversies, cardiac arrest, and diagnosis and treatment of mechanical complications, as well as multivessel and left main-related STEMI.

show abstract

Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease

Cited by 45 publications

References 25 publications

Complete Revascularization in Patients With STEMI and Multivessel Coronary Artery Disease: Is It Beneficial?

Complete Revascularization in Patients With STEMI and Multivessel Coronary Artery Disease: Is It Beneficial?

Multivessel percutaneous coronary intervention with thin-strut biodegradable versus durable polymer drug-eluting stents in ST-segment elevation myocardial infarction: A subgroup analysis of the BIOSTEMI randomized trial

Management of ST-Elevation Myocardial Infarction in High-Risk Settings

Contact Info

Product

Resources

About