Optimal Timing of Angiography-Guided Complete Revascularization of Non-Culprit Lesions in STEMI Patients with Multivessel Disease
Abstract
:1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
4. Discussion
Limitations of the Study and Future Directions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Jobs, A.; Desch, S.; Freund, A.; Feistritzer, H.-J.; Thiele, H. Revascularization Strategy in Myocardial Infarction with Multivessel Disease. J. Clin. Med. 2024, 13, 1918. [Google Scholar] [CrossRef] [PubMed]
- Toma, M.; Buller, C.E.; Westerhout, C.M.; Fu, Y.; O'Neill, W.W.; Holmes, D.R., Jr.; Hamm, C.W.; Granger, C.B.; Armstrong, P.W. for the APEX-AMI Investigators. Non-culprit coronary artery percutaneous coronary intervention during acute ST-segment elevation myocardial infarction: Insights from the APEX-AMI trial. Eur. Heart J. 2010, 31, 1701–1707. [Google Scholar] [CrossRef] [PubMed]
- Neumann, F.-J.; Sousa-Uva, M.; Ahlsson, A.; Alfonso, F.; Banning, A.P.; Benedetto, U.; Byrne, R.A.; Collet, J.-P.; Falk, V.; Head, S.J.; et al. ESC Scientific Document Group, 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur. Heart J. 2019, 40, 87–165. [Google Scholar] [CrossRef]
- Mehta, S.R.; Wood, D.A.; Storey, R.F.; Mehran, R.; Bainey, K.R.; Nguyen, H.; Meeks, B.; Di Pasquale, G.; López-Sendón, J.; Faxon, D.P.; et al. Complete Revascularization with Multivessel PCI for Myocardial Infarction. N. Engl. J. Med. 2019, 381, 1411–1421. [Google Scholar] [CrossRef]
- Byrne, R.A.; ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes: Developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC). Eur. Heart J. 2023, 44, 3720–3826. [Google Scholar] [CrossRef]
- Wald, D.S.; Morris, J.K.; Wald, N.J.; Chase, A.J.; Edwards, R.J.; Hughes, L.O.; Berry, C.; Oldroyd, K.G. Randomized Trial of Preventive Angioplasty in Myocardial Infarction. N. Engl. J. Med. 2013, 369, 1115–1123. [Google Scholar] [CrossRef]
- Gershlick, A.H.; Khan, J.N.; Kelly, D.J.; Greenwood, J.P.; Sasikaran, T.; Curzen, N.; Blackman, D.J.; Dalby, M.; Fairbrother, K.L.; Banya, W.; et al. Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: The CvLPRIT trial. J. Am. Coll. Cardiol. 2015, 65, 963–972. [Google Scholar] [CrossRef] [PubMed]
- Engstrøm, T.; Kelbæk, H.; Helqvist, S.; Høfsten, D.E.; Kløvgaard, L.; Holmvang, L.; Jørgensen, E.; Pedersen, F.; Saunamäki, K.; Clemmensen, P.; et al. 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, randomized controlled trial. Lancet 2015, 386, 665–671. [Google Scholar] [CrossRef]
- Smits, P.C.; Abdel-Wahab, M.; Neumann, F.J.; Boxma-de Klerk, B.M.; Lunde, K.; Schotborgh, C.E.; Piroth, Z.; Horak, D.; Wlodarczak, A.; Ong, P.J.; et al. Fractional flow reserve-guided multivessel angioplasty in myocardial infarction. N. Engl. J. Med. 2017, 376, 1234–1244. [Google Scholar] [CrossRef]
- Wood, D.A.; Cairns, J.A.; Wang, J.; Mehran, R.; Storey, R.F.; Nguyen, H.; Meeks, B.; Kunadian, V.; Tanguay, J.-F.; Kim, H.-H.; et al. Timing of Staged Non culprit Artery Revascularization in Patients With ST-Segment Elevation Myocardial Infarction: COMPLETE trial. J. Am. Coll. Cardiol. 2019, 74, 2713–2723. [Google Scholar] [CrossRef]
- Stähli, B.E.; Varbella, F.; Linke, A.; Schwarz, B.; Felix, S.B.; Seiffert, M.; Kesterke, R.; Nordbeck, P.; Witzenbichler, B.; Lang, I.M.; et al. Timing of Complete Revascularization with Multivessel PCI for Myocardial Infarction. N. Engl. J. Med. 2023, 389, 1368–1379. [Google Scholar] [CrossRef]
- Diletti, R.; den Dekker, W.K.; Bennett, J.; Schotborgh, C.E.; van der Schaaf, R.; Sabaté, M.; Moreno, R.; Ameloot, K.; van Bommel, R.; Forlani, D.; et al. Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): A prospective, open-label, noninferiority, randomized trial. Lancet 2023, 401, 1172–1182. [Google Scholar] [CrossRef] [PubMed]
- Gaffar, R.; Habib, B.; Filion, K.B.; Reynier, P.; Eisenberg, M.J. Optimal Timing of Complete Revascularization in Acute Coronary Syndrome: A Systematic Review and Meta-Analysis. J. Am. Heart Assoc. 2017, 6, e005381. [Google Scholar] [CrossRef] [PubMed]
- Sardella, G.; Lucisano, L.; Garbo, R.; Pennacchi, M.; Cavallo, E.; Stio, R.E.; Calcagno, S.; Ugo, F.; Boccuzzi, G.; Fedele, F.; et al. Single-staged compared with multi-staged PCI in multivessel NSTEMI patients: The SMILE trial. J. Am. Coll. Cardiol. 2016, 67, 264–272. [Google Scholar] [CrossRef]
- Politi, L.; Sgura, F.; Rossi, R.; Monopoli, D.; Guerri, E.; Leuzzi, C.; Bursi, F.; Sangiorgi, G.M.; Modena, M.G. A randomized trial of target-vessel versus multivessel revascularisation in ST-elevation myocardial infarction: Major adverse cardiac events during long-term follow-up. Heart 2010, 96, 662–667. [Google Scholar] [CrossRef] [PubMed]
- Ochala, A.; Smolka, G.A.; Wojakowski, W.; Dudek, D.; Dziewierz, A.; Krolikowski, Z.; Gasior, Z.; Tendera, M. The function of the left ventricle after complete multivessel one-stage percutaneous coronary intervention in patients with acute myocardial infarction. J. Invasive Cardiol. 2004, 16, 699–702. [Google Scholar] [PubMed]
- Tarasov, R.S. Six month results of randomized clinical trial: Multivessel stenting in primary percutaneous coronary intervention and staged revascularization for ST-elevation myocardial infarction patients with second generation drug eluting stents. Clin. Med. Res. 2014, 3, 125. [Google Scholar] [CrossRef]
- Li, Z.; Zhou, Y.; Xu, Q.; Chen, X. Staged versus one-time complete revascularization with percutaneous coronary intervention in STEMI patients with multivessel disease: A systematic review and meta-analysis. PLoS ONE 2017, 12, e0169406. [Google Scholar] [CrossRef]
- Ahmad, Y.; Howard, J.P.; Arnold, A.; Prasad, M.; Seligman, H.; Cook, C.M.; Warisawa, T.; Shun-Shun, M.; Ali, Z.; Parikh, M.A.; et al. Complete Revascularization by Percutaneous Coronary In-tervention for Patients With ST-Segment-Elevation Myocardial Infarction and Multivessel Coronary Artery Disease: An Updated Meta-Analysis of Randomized Trials. J. Am. Heart Assoc. 2020, 9, e015263. [Google Scholar] [CrossRef]
- Pavasini, R.; Biscaglia, S.; Barbato, E.; Tebaldi, M.; Dudek, D.; Escaned, J.; Casella, G.; Santarelli, A.; Guiducci, V.; Gutierrez-Ibanes, E.; et al. Complete revascularization reduces cardiovascular death in patients with ST-segment elevation myocardial infarction and multivessel disease: Systematic review and meta-analysis of randomized clinical trials. Eur. Heart J. 2020, 41, 4103–4110. [Google Scholar] [CrossRef]
- Osman, M.; Khan, S.U.; Farjo, P.D.; Chima, N.; Kheiri, B.; Zahr, F.; Alkhouli, M. Meta-Analysis Comparing Complete Versus Infarct-Related Artery Revascularization in Patients With ST-Elevation Myocardial Infarction and Multivessel Coronary Disease. Am. J. Cardiol. 2020, 125, 513–520. [Google Scholar] [CrossRef] [PubMed]
- Sucato, V.; Coppola, G.; Testa, G.; Amata, F.; Martello, M.; Siddique, R.; Galassi, A.R.; Novo, G.; Corrado, E. Evaluation of remnant cholesterol levels and Monocyte-to- HDL-cholesterol ratio in South Asian patients with acute coronary syndrome. Nutr. Metab. Cardiovasc. Dis. 2021, 31, 2144–2150. [Google Scholar] [CrossRef] [PubMed]
- Sucato, V.; Madaudo, C.; Galassi, A.R. Classification, Diagnosis, and Treatment of Coronary Microvascular Dysfunction. J. Clin. Med. 2022, 11, 4610. [Google Scholar] [CrossRef] [PubMed]
- Cuculi, F.; De Maria, G.L.; Meier, P.; Dall’Armellina, E.; de Caterina, A.R.; Channon, K.M.; Prendergast, B.D.; Choudhury, R.C.; Forfar, J.C.; Kharbanda, R.K.; et al. Impact of microvascular obstruction on the assessment of coronary flow reserve, index of microcirculatory resistance, and fractional flow reserve after ST-segment elevation myocardial infarction. J. Am. Coll. Cardiol. 2014, 64, 1894–1904. [Google Scholar] [CrossRef]
- Mehran, R.; Dangas, G.D.; Weisbord, S.D. Contrast-Associated Acute Kidney Injury. N. Engl. J. Med. 2019, 380, 2146–2155. [Google Scholar] [CrossRef]
- Sucato, V.; Corrado, E.; Manno, G.; Amata, F.; Testa, G.; Novo, G.; Galassi, A.R. Biomarkers of Coronary Microvascular Dysfunction in Patients with Microvascular Angina: A Narrative Review. Angiology 2022, 73, 395–406. [Google Scholar] [CrossRef]
- Pravda, N.S.; Witberg, G.; Zusman, O.; Landes, U.; Bental, T.; Assali, A.; Hana, V.A.; Gabriel, G.; Pablo, C.; Leor, P.; et al. A risk score based on simple angiographic characteristics to aid in choosing the optimal revascularization strategy for patients with multivessel disease presenting with ST-elevation myocardial infarction. Coron. Artery Dis. 2020, 31, 597–605. [Google Scholar] [CrossRef]
- Xie, Y.; Mintz, G.S.; Yang, J.; Doi, H.; Iñiguez, A.; Dangas, G.D.; Serruys, P.W.; McPherson, J.A.; Wennerblom, B.; Xu, K.; et al. Clinical outcome of nonculprit plaque ruptures in patients with acute coronary syndrome in the PROSPECT study. JACC Cardiovasc. Imaging 2014, 7, 397–405. [Google Scholar] [CrossRef]
- Bergamaschi, L.; Landi, A.; Maurizi, N.; Pizzi, C.; Leo, L.A.; Arangalage, D.; Iglesias, J.F.; Eeckhout, E.; Schwitter, J.; Valgimigli, M.; et al. Acute Response of the Noninfarcted Myocardium and Surrounding Tissue Assessed by T2 Mapping After STEMI. JACC Cardiovasc. Imaging 2024, 17, 610–621. [Google Scholar] [CrossRef]
- Pinilla-Echeverri, N.; Mehta, S.R.; Wang, J.; Lavi, S.; Schampaert, E.; Cantor, W.J.; Bainey, K.R.; Welsh, R.C.; Kassam, S.; Mehran, R.; et al. Nonculprit Lesion Plaque Morphology in Patients with ST-Segment-Elevation Myocardial Infarction: Results from the COMPLETE Trial Optical Coherence Tomography Substudys. Circ. Cardiovasc. Interv. 2020, 13, e008768. [Google Scholar] [CrossRef]
Variables | Screened Population n. (%) | Enrolled Population n. (%) | Index PCI n. (%) | Staged PCI n. (%) | p Value |
---|---|---|---|---|---|
n = 230 | n = 87 | n = 59 | n = 28 | ||
Male sex | 160 (69.5) | 61 (70.1) | 41 (69.5) | 20 (71.4) | 0.85 |
Age | 58.5 ± 10 | 61 ± 14 | 60 ± 14 | 62 ± 13 | 0.52 |
Hypertension | 146 (63.4) | 64 (73.5) | 43 (72.8) | 21 (75) | 0.83 |
Diabetes | 64 (27.8) | 27 (31) | 17 (28.8) | 10 (35.7) | 0.58 |
Smoking | 123 (53.4) | 53 (61) | 37 (62.7) | 16 (57) | 0.61 |
Dyslipidemia | 75 (32.6) | 32 (36.8) | 21 (35.9) | 11 (39.2) | 0.73 |
History of CV diseases | 103 (47.7) | 40 (46) | 29 (49.1) | 11 (39.2) | 0.38 |
Multivessel disease | 97 (42.1) | 87 (100) | 59 (100) | 28 (100) | NS |
Non-IRA revascularization strategy | 87 (37.8) | 87 (100) | 59 (100) | 28 (100) | NS |
Enrolled Population n. (%) | Index PCI n. (%) | Staged PCI n. (%) | OR | 95% CI | p Value | |
---|---|---|---|---|---|---|
n = 87 | n = 59 | n = 28 | ||||
MACCE | 16 (18.4) | 7 (11.9) | 9 (32.1) | 3.52 | 1.25 to 10.77 | 0.022 |
Death from any cause | 11 (12.6) | 5 (8.47) | 6 (21.4) | 2.95 | 0.81 to 10.66 | 0.084 |
Myocardial infarction | 5 (5.7) | 2 (3.4) | 3 (10.7) | 3.42 | 0.54 to 21.75 | 0.170 |
TLR | 3 (3.5) | 2 (3.4) | 1 (3.6) | 1.06 | 0.09 to 12.16 | 0.965 |
New angina episodes | 3 (3.5) | 1 (1.7) | 2 (7.1) | 4.46 | 0.39 to 51.43 | 0.193 |
New hospitalization | 2 (2.3) | 2 (3.4) | 0 | - | - | 0.324 |
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Sucato, V.; Madaudo, C.; Marotta, A.; Ortello, A.; Camarda, E.A.; Comparato, F.; Galassi, A.R. Optimal Timing of Angiography-Guided Complete Revascularization of Non-Culprit Lesions in STEMI Patients with Multivessel Disease. J. Clin. Med. 2024, 13, 5070. https://doi.org/10.3390/jcm13175070
Sucato V, Madaudo C, Marotta A, Ortello A, Camarda EA, Comparato F, Galassi AR. Optimal Timing of Angiography-Guided Complete Revascularization of Non-Culprit Lesions in STEMI Patients with Multivessel Disease. Journal of Clinical Medicine. 2024; 13(17):5070. https://doi.org/10.3390/jcm13175070
Chicago/Turabian StyleSucato, Vincenzo, Cristina Madaudo, Antonia Marotta, Antonella Ortello, Emmanuele Antonio Camarda, Francesco Comparato, and Alfredo Ruggero Galassi. 2024. "Optimal Timing of Angiography-Guided Complete Revascularization of Non-Culprit Lesions in STEMI Patients with Multivessel Disease" Journal of Clinical Medicine 13, no. 17: 5070. https://doi.org/10.3390/jcm13175070