Complete revascularisation in patients with ST-segment elevation myocardial infarction and multivessel disease: contemporary data in context

Commentary on: Engstrøm T, Kelbæk H, Helqvist S, et al.. DANAMI-3—PRIMULTI Investigators. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3—PRIMULTI): an open-label, randomised controlled trial. Lancet 2015;386:665–71. Context Primary percutaneous coronary intervention is recommended in patients presenting with ST-segment Elevation Myocardial infarction (STEMI).1 In 40–60% of STEMI patients there is disease in non-infarct-related arteries (IRAs).2 Such patients have higher mortality rates and incidence of MI.3 Current guidelines suggest PCI should be undertaken to the IRA only.1 However, these were based on numerous, potentially selected-patient retrospective observational studies. The DANAMI-3-PRIMULTI investigators compared complete and culprit-only revascularisation in patients with STEMI and multivessel disease. Methods PRIMULTI was a prospective multicentre open-label randomised controlled trial. Patients within 12 h of STEMI were initially randomised to either deferred stenting (DANAMI-3-DEFER)...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Therapeutics/Prevention Source Type: research