Myocardial Infarction Clinical Trial
Official title:
Complete Revascularization Or streSS Echo in Patients With Multivessel Disease and ST-segment Elevation Acute Myocardial Infarction
Multivessel disease has been reported to occur between 40 and 60% of patients with
ST-segment elevation myocardial infarction (STEMI) and has been associated to a worse
prognosis. Multivessel revascularization offers a myriad of potential advantages as enhance
of the collateral blood flow, greater myocardial salvage, the stabilization of other lesions
that can be potentially vulnerable, and the achievement of a complete revascularization,
factor that is associated with a better prognosis. On the other hand, the prolongation of
procedural duration, the hazard of contrast induced nephropathy and the peri-procedural
complications can limit the widespread of this practice.
To date, very few observational studies have focused in the multivessel revascularization
with disparity of results. Whereas ones have observed an increase of adverse cardiovascular
events and thus not recommend it, others have shown neutral results.
Stress echocardiography has been shown to be an adequate technique for the diagnosis of
coronary artery disease and could be an appropriate tool for selecting the lesions that need
to be revascularized because they induce large areas of ischemia. However, this technique
has also limitations like the high operator-dependence.
Therefore, the investigators sought to study if the complete multivessel revascularization
of patients with STEMI treated by means of primary percutaneous coronary intervention (PCI)
has an impact on prognosis compared to a strategy of treating only those non-culprit lesions
that produce large areas of ischemia in a stress test.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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