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Timing of Staged No...
Timing of Staged Nonculprit Artery Revascularization in Patients With ST-Segment Elevation Myocardial Infarction COMPLETE Trial
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- Wood, David A. (author)
- Univ British Columbia, St Pauls & Vancouver Gen Hosp, Ctr Cardiovasc Innovat, 2775 Laurel St 9th Floor, Vancouver, BC V5Z 1M9, Canada
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- Cairns, John A. (author)
- Univ British Columbia, St Pauls & Vancouver Gen Hosp, Ctr Cardiovasc Innovat, 2775 Laurel St 9th Floor, Vancouver, BC V5Z 1M9, Canada
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- Wang, Jia (author)
- McMaster Univ, Populat Hlth Res Inst, 237 Barton St East, Hamilton, ON L8L 2X2, Canada;Hamilton Hlth Sci, 237 Barton St East, Hamilton, ON L8L 2X2, Canada
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- Mehran, Roxana (author)
- Zena A Wiener Cardiovasc Inst, Icahn Sch Med Mt Sinai, New York, NY USA
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- Storey, Robert F. (author)
- Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England
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- Nguyen, Helen (author)
- McMaster Univ, Populat Hlth Res Inst, 237 Barton St East, Hamilton, ON L8L 2X2, Canada;Hamilton Hlth Sci, 237 Barton St East, Hamilton, ON L8L 2X2, Canada
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- Meeks, Brandi (author)
- McMaster Univ, Populat Hlth Res Inst, 237 Barton St East, Hamilton, ON L8L 2X2, Canada;Hamilton Hlth Sci, 237 Barton St East, Hamilton, ON L8L 2X2, Canada
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- Kunadian, Vijay (author)
- Newcastle Univ, Inst Cellular Med, Fac Med Sci, Newcastle Upon Tyne, Tyne & Wear, England;Newcastle Tyne Hosp NHS Fdn Trust, Cardiothorac Ctr, Freeman Hosp, Newcastle Upon Tyne, Tyne & Wear, England
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- Tanguay, Jean-Francois (author)
- Montreal Heart Inst, Montreal, PQ, Canada;Univ Montreal, Montreal, PQ, Canada
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- Kim, Hahn-Ho (author)
- St Marys Gen Hosp, Kitchener, ON, Canada
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- Cheema, Asim (author)
- St Michaels Hosp, Toronto, ON, Canada
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- Deghani, Payam (author)
- Univ Saskatchewan, Prairie Vasc Res Network, Regina, SK, Canada
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- Natarajan, Madhu K. (author)
- McMaster Univ, Populat Hlth Res Inst, 237 Barton St East, Hamilton, ON L8L 2X2, Canada;Hamilton Hlth Sci, 237 Barton St East, Hamilton, ON L8L 2X2, Canada
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- Jolly, Sanjit S. (author)
- McMaster Univ, Populat Hlth Res Inst, 237 Barton St East, Hamilton, ON L8L 2X2, Canada;Hamilton Hlth Sci, 237 Barton St East, Hamilton, ON L8L 2X2, Canada
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- Amerena, John (author)
- Kardinia House, Geelong, Vic, Australia
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- Keltai, Matyas (author)
- Hungarian Inst Cardiol, Budapest, Hungary
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- James, Stefan, 1964- (author)
- Uppsala universitet,Kardiologi
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- Hlinomaz, Ota (author)
- Univ Hosp St Anne, Brno, Czech Republic
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- Niemela, Kari (author)
- Tampere Univ Hosp, Heart Ctr, Tampere, Finland
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- AlHabib, Khalid (author)
- King Fahad Cardiac Ctr, Dept Cardiac Serv, Jeddah, Saudi Arabia
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- Lewis, Basil S. (author)
- Lady Davis Carmel Med Ctr, Cardiovasc Clin Res Inst, Haifa, Israel
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- Nguyen, Michel (author)
- Univ Sherbrooke, Ctr Hosp, Div Cardiol, Quebec City, PQ, Canada
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- Sarma, Jaydeep (author)
- Wythenshawe Hosp, North West Heart Ctr, Manchester, Lancs, England
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- Dzavik, Vladimir (author)
- Univ Hlth Network, Peter Munk Cardiac Ctr, Toronto, ON, Canada
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- Della Siega, Anthony (author)
- Victoria Heart Inst Fdn, Dept Cardiac Serv, Victoria, BC, Canada
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- Mehta, Shamir R. (author)
- McMaster Univ, Populat Hlth Res Inst, 237 Barton St East, Hamilton, ON L8L 2X2, Canada;Hamilton Hlth Sci, 237 Barton St East, Hamilton, ON L8L 2X2, Canada
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(creator_code:org_t)
- ELSEVIER SCIENCE INC, 2019
- 2019
- English.
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In: Journal of the American College of Cardiology. - : ELSEVIER SCIENCE INC. - 0735-1097 .- 1558-3597. ; 74:22, s. 2713-2723
- Related links:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Subject headings
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- BACKGROUND The COMPLETE (Complete vs Culprit-only Revascularization to Treat Multi-vessel Disease After Early PCI for STEMI) trial demonstrated that staged nonculprit lesion percutaneous coronary intervention (PCI) reduced major cardiovascular (CV) events in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (CAD). OBJECTIVES The purpose of this study was to determine the effect of nonculprit-lesion PCI timing on major CV outcomes and also the time course of the benefit of complete revascularization. METHODS Following culprit-lesion PCI, 4,041 patients with STEMI and multivessel CAD were randomized to staged nonculprit-lesion PCI or culprit-lesion only PCI. Randomization was stratified according to investigator-planned timing of nonculprit-lesion PCI: during or after the index hospitalization. The first coprimary outcome was the composite of CV death or myocardial infarction (MI). In pre-specified analyses, hazard ratios (HRs) were calculated for each time stratum. Landmark analyses of the entire population were performed within 45 days and after 45 days. RESULTS For nonculprit-lesion PCI planned during the index hospitalization (actual time: median 1 day), CV death or MI was reduced with complete revascularization compared with culprit-lesion only PCI (HR: 0.77; 95% confidence interval [CI]: 0.59 to 1.00). For nonculprit lesion PCI planned to occur after hospital discharge (actual time: median 23 days), CV death or MI was also reduced with complete revascularization (HR: 0.69; 95% CI: 0.49 to 0.97; interaction p = 0.62). Landmark analyses demonstrated an HR of 0.86 (95% CI: 0.59 to 1.24) during the first 45 days and 0.69 (95% CI: 0.54 to 0.89) from 45 days to the end of follow-up for intended nonculprit lesion PCI versus culprit lesion only PCI. CONCLUSIONS Among STEMI patients with multivessel disease, the benefit of complete revascularization over culprit-lesion only PCI was consistent irrespective of the investigator-determined timing of nonculprit-lesion intervention. The benefit of complete revascularization on hard clinical outcomes emerged mainly over the long term. (C) 2019 by the American College of Cardiology Foundation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- complete revascularization
- percutaneous coronary intervention
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Wood, David A.
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Cairns, John A.
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Wang, Jia
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Mehran, Roxana
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Storey, Robert F ...
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Nguyen, Helen
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show more...
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Meeks, Brandi
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Kunadian, Vijay
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Tanguay, Jean-Fr ...
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Kim, Hahn-Ho
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Cheema, Asim
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Deghani, Payam
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Natarajan, Madhu ...
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Jolly, Sanjit S.
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Amerena, John
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Keltai, Matyas
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James, Stefan, 1 ...
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Hlinomaz, Ota
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Niemela, Kari
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AlHabib, Khalid
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Lewis, Basil S.
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Nguyen, Michel
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Sarma, Jaydeep
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Dzavik, Vladimir
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Della Siega, Ant ...
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Mehta, Shamir R.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Journal of the A ...
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Uppsala University