%0 Journal Article
%A Karthikeyan, Ganesan
%A Peix, Amalia
%A Devasenapathy, Niveditha
%A Jimenez-Heffernan, Amelia
%A Haque, Saif-Ul
%A Rodella, Carlo
%A Giubbini, Raffaele
%A Rosas, Erick Alexanderson
%A Ozkan, Elgin
%A Keng, Yung Jih Felix
%A Vitola, João
%A Sobic-Saranovic, Dragana
%A Soni, Manoj
%A López, Leonardo
%A Cabrera, Lázaro O
%A Camacho-Freire, Santiago
%A Manovel-Sanchez, Ana
%A Naeem, Hesham
%A Fatima, Shazia
%A Rinaldi, Roberto
%A Carvajal-Juarez, Isabel
%A Esenboga, Kerim
%A Dondi, Maurizio
%A Paez, Diana
%T Ischemia-guided vs routine non-culprit vessel angioplasty for patients with ST segment elevation myocardial infarction and multi-vessel disease: the IAEA SPECT STEMI trial.
%D 2022
%U http://hdl.handle.net/10668/21274
%X In patients with multi-vessel disease presenting with ST elevation myocardial infarction (STEMI), the efficacy and safety of ischemia-guided, vs routine non-culprit vessel angioplasty has not been adequately studied. We conducted an international, randomized, non-inferiority trial comparing ischemia-guided non-culprit vessel angioplasty to routine non-culprit vessel angioplasty, following primary PCI for STEMI. The primary outcome was the between-group difference in percent ischemic myocardium at follow-up stress MPI. All MPI images were processed and analyzed at a central core lab, blinded to treatment allocation. In all, 109 patients were enrolled from nine countries. In the ischemia-guided arm, 25/48 (47%) patients underwent non-culprit vessel PCI following stress MPI. In the routine non-culprit PCI arm, 43/56 (77%) patients underwent angioplasty (86% within 6 weeks of randomization). The median percentage of ischemic myocardium on follow-up imaging (mean 16.5 months) was low, and identical (2.9%) in both arms (difference 0.13%, 95%CI - 1.3%-1.6%, P  A strategy of ischemia-guided non-culprit PCI resulted in low ischemia burden, and was non-inferior to a strategy of routine non-culprit vessel PCI in reducing ischemia burden. Selective non-culprit PCI following STEMI offers the potential for cost-savings, and may be particularly relevant to low-resource settings. (CTRI/2018/08/015384).
%K MPI
%K Myocardial ischemia and infarction
%K SPECT
%~