الفهرس 
St Segment Elevation Myocardial Infarction (STEMI)Only 14 pages are availabe for public view
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Abstract
Background: Complete revascularization has been recently popularized for management of ST-segment–elevation myocardial infarction (STEMI) patients with multivessel disease scheduled for primary percutaneous coronary intervention (PPCI). We assessed the three months outcomes of compete revascularization (CR) compared to staged revascularization in patients with multivessel disease undergoing PPCI.
Materials and Methods: We conducted a randomized, open-label, comparative trial on STEMI patients with multivessel disease scheduled to undergo PPCI at the physician’s discretion. Patients were randomly assigned to undergo PCI revascularization of the non-culprit lesions during the index procedure (CR) or within 30 days later after discharge (staged revascularization). The primary endpoint was the 6-point major adverse cardiovascular events (MACE), composed of all-cause mortality, re-infarction, heart failure (HF), recurrence of angina symptoms, cerebrovascular stroke, and need for revascularization.
Results: A total of 100 patients were randomized in 1:1 ratio. The 6-point MACE occurred in 24% of the patients in CR and 20% in staged revascularization group (p =0.62). The incidence of HF (14% versus 12%; p =0.76), repeated revascularization (4% in each group), persistent angina (8 versus 2%, p =0.16), all-cause mortality (2% in each group), MI (4% in each group), stent thrombosis (0% versus 4%; p =0.15), and cerebrovascular accident (0% versus 2%; p =0.32) was comparable between both groups.
Conclusion: Staged revascularization provided comparable short-term benefits to complete revascularization in STEMI patients with multivessel disease undergoing PPCI. The present trial demonstrated that complete revascularization was associated with a trend towards higher incidence of stent thrombosis and CVT than stage revascularization.