RT Journal Article
T1 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.
A1 Karthikeyan, Ganesan
A1 Peix, Amalia
A1 Devasenapathy, Niveditha
A1 Jimenez-Heffernan, Amelia
A1 Haque, Saif-Ul
A1 Rodella, Carlo
A1 Giubbini, Raffaele
A1 Rosas, Erick Alexanderson
A1 Ozkan, Elgin
A1 Keng, Yung Jih Felix
A1 Vitola, João
A1 Sobic-Saranovic, Dragana
A1 Soni, Manoj
A1 López, Leonardo
A1 Cabrera, Lázaro O
A1 Camacho-Freire, Santiago
A1 Manovel-Sanchez, Ana
A1 Naeem, Hesham
A1 Fatima, Shazia
A1 Rinaldi, Roberto
A1 Carvajal-Juarez, Isabel
A1 Esenboga, Kerim
A1 Dondi, Maurizio
A1 Paez, Diana
K1 MPI
K1 Myocardial ischemia and infarction
K1 SPECT
AB 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).
YR 2022
FD 2022-10-25
LK http://hdl.handle.net/10668/21274
UL http://hdl.handle.net/10668/21274
LA en
DS RISalud
RD Apr 12, 2025