PMID- 27245121
OWN - NLM
STAT- MEDLINE
DCOM- 20170504
LR  - 20220330
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Linking)
VI  - 29
IP  - 3
DP  - 2016 Jun
TI  - A Randomized Trial of Complete Versus Culprit-Only Revascularization During 
      Primary Percutaneous Coronary Intervention in Diabetic Patients With Acute ST 
      Elevation Myocardial Infarction and Multi Vessel Disease.
PG  - 241-7
LID - 10.1111/joic.12293 [doi]
AB  - BACKGROUND: Recent randomized trials and meta-analyses demonstrated that a 
      complete revascularization of significant non culprit lesions in patients with ST 
      elevation myocardial infarction (STEMI) is superior to a culprit only 
      revascularization approach in reducing major adverse cardiac events (MACE), 
      however the proportion of diabetic patients was low in these trials. OBJECTIVES: 
      To investigate whether a complete revascularization approach is associated with 
      better outcomes in diabetic patients with STEMI and multi-vessel disease. 
      METHODS: One hundred diabetic patients with acute STEMI with at least one 
      non-culprit lesion were randomized to either complete revascularization (n = 50) 
      or culprit-only treatment (n = 50). Complete revascularization was performed 
      either at the time of primary percutaneous coronary intervention (PCI) or within 
      72 hours during hospitalization. The primary endpoint was the composite of 
      all-cause mortality, recurrent MI, and ischemia-driven revascularization at 6 
      months. RESULTS: A complete revascularization approach was significantly 
      associated with a reduction in the primary outcome (6% vs. 24%, P = 0.01), 
      primarily due to reduction in ischemia driven revascularization in the complete 
      revascularization group (2% vs. 12%; P = 0.047). There was no significant 
      reduction in death or MI (2% vs. 8%; P = 0.17) and (2% vs. 4%; P = 0.56) 
      respectively, or in the safety endpoints of major or minor bleeding, 
      contrast-induced nephropathy, or stroke between the groups. CONCLUSIONS: In 
      diabetic patients with multi-vessel coronary artery disease undergoing PPCI, 
      complete revascularization is associated with significantly reduced risk of 
      adverse cardiovascular events, as compared with culprit vessel only PCI. (J 
      Interven Cardiol 2016;29:241-247).
CI  - (c) 2016, Wiley Periodicals, Inc.
FAU - Hamza, Mohamed
AU  - Hamza M
AD  - Department of Cardiology, Ain-Shams University, Cairo, Egypt.
FAU - Mahmoud, Ahmed
AU  - Mahmoud N
AD  - Division of Cardiology, Department of Medicine, University of Florida, 
      Gainesville, Florida.
FAU - Elgendy, Islam Y
AU  - Elgendy IY
AD  - Department of Medicine, University of Florida, Gainesville, Florida.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
SB  - IM
EIN - J Interv Cardiol. 2016 Aug;29(4):441. PMID: 27476860
MH  - Aged
MH  - Diabetes Mellitus/*surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Revascularization/adverse effects/*methods/mortality
MH  - Percutaneous Coronary Intervention/adverse effects/*methods/mortality
MH  - Postoperative Complications
MH  - Prospective Studies
MH  - ST Elevation Myocardial Infarction/complications/*surgery
MH  - Treatment Outcome
EDAT- 2016/06/02 06:00
MHDA- 2017/05/05 06:00
CRDT- 2016/06/02 06:00
PHST- 2016/06/02 06:00 [entrez]
PHST- 2016/06/02 06:00 [pubmed]
PHST- 2017/05/05 06:00 [medline]
AID - 10.1111/joic.12293 [doi]
PST - ppublish
SO  - J Interv Cardiol. 2016 Jun;29(3):241-7. doi: 10.1111/joic.12293.