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The Anatolian Journal of Cardiology A trial comparing complete revascularization during primary percutaneous coronary intervention versus the index hospital admission in multivessel coronary disease patients with ST-elevation myocardial infarction uncomplicated by shock [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-71080

A trial comparing complete revascularization during primary percutaneous coronary intervention versus the index hospital admission in multivessel coronary disease patients with ST-elevation myocardial infarction uncomplicated by shock

Mihnea Traian Nichita Brendea1, Mircea Ioachim Popescu2, Virgil Popa1, Dorina Carmen Polojintef Corbu2
1Department of Cardiology, Emergency Clinical County hospital of Oradea, Oradea, Romania
2Faculty of Medicine and Pharmacology, University of Oradea, Oradea, Romania

Objectives
The study aimed to compare major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of death, stroke, myocardial infarction and symptom induced revascularization, and mortality within one year of randomization between two strategies: complete revascularization including non-culprit lesions percutaneous coronary intervention (PCI) during primary PCI(PPCI) versus complete revascularisation during the same hospital admission in multi-vascular coronary artery disease(MVD) patients presenting with ST-elevation myocardial infarction (STEMI) uncomplicated by cardiogenic shock.
Methods
We randomized in a 1: 1 manner 100 MVD patients with STEMI uncomplicated by cardiogenic shock who had undergone successful culprit-lesion PCI to either a strategy of complete revascularization with PCI of angiographically significant non-culprit lesions in the index PPCI procedure or to a strategy of complete revascularization during a second procedure that took place during the same hospital admission.
Results
The first primary outcome was death within a timeframe of one year and the second a composite of MACCE within a year following complete revascularization.
Of the total number of patients monitored, 4% in each of the two groups was associated with the first primary outcome (P=0.9835) while the second primary outcome in 6% (P=0.9698). There was no statistical difference between outcomes in the two groups.
Conclusions
Among MVD patients with STEMI uncomplicated by cardiogenic shock, there was no difference regarding outcomes when using a strategy of complete revascularization of non-culprit lesions during PPCI or the same hospital admission.

Keywords: PPCI, multi-vessel coronary artery disease, STEMI



Corresponding Author: Mihnea Traian Nichita Brendea, Romania