PMID- 31000010
OWN - NLM
STAT- MEDLINE
DCOM- 20200608
LR  - 20200608
IS  - 1876-7605 (Electronic)
IS  - 1936-8798 (Linking)
VI  - 12
IP  - 8
DP  - 2019 Apr 22
TI  - Complete Revascularization Versus Culprit Lesion Only in Patients With ST-Segment 
      Elevation Myocardial Infarction and Multivessel Disease: A DANAMI-3-PRIMULTI 
      Cardiac Magnetic Resonance Substudy.
PG  - 721-730
LID - S1936-8798(19)30572-2 [pii]
LID - 10.1016/j.jcin.2019.01.248 [doi]
AB  - OBJECTIVES: The aim of this study was to evaluate the effect of fractional flow 
      reserve (FFR)-guided revascularization compared with culprit-only percutaneous 
      coronary intervention (PCI) in patients with ST-segment elevation 
      myocardial infarction (STEMI) on infarct size, left ventricular (LV), function, 
      LV remodeling, and the presence of nonculprit infarctions. BACKGROUND: Patients 
      with STEMI with multivessel disease might have improved clinical outcomes after 
      complete revascularization compared with PCI of the infarct-related artery only, 
      but the impact on infarct size, LV function, and remodeling as well as the risk 
      for periprocedural infarction are unknown. METHODS: In this substudy of the 
      DANAMI-3 (Third Danish Trial in Acute Myocardial Infarction)-PRIMULTI (Primary 
      PCI in Patients With ST-Elevation Myocardial Infarction and Multivessel Disease: 
      Treatment of Culprit Lesion Only or Complete Revascularization) randomized trial, 
      patients with STEMI with multivessel disease were randomized to receive either 
      complete FFR-guided revascularization or PCI of the culprit vessel only. The 
      patients underwent cardiac magnetic resonance imaging during index admission and 
      at 3-month follow-up. RESULTS: A total of 280 patients (136 patients with 
      infarct-related and 144 with complete FFR-guided revascularization) were 
      included. There were no differences in final infarct size (median 12% 
      [interquartile range: 5% to 19%] vs. 11% [interquartile range: 4% to 18%]; p = 
      0.62), myocardial salvage index (median 0.71 [interquartile range: 0.54 to 0.89] 
      vs. 0.66 [interquartile range: 0.55 to 0.87]; p = 0.49), LV ejection fraction 
      (mean 58 +/- 9% vs. 59 +/- 9%; p = 0.39), and LV end-systolic volume remodeling (mean 
      7 +/- 22 ml vs. 7 +/- 19 ml; p = 0.63). New nonculprit infarction occurring after the 
      nonculprit intervention was numerically more frequent among patients treated with 
      complete revascularization (6 [4.5%] vs. 1 [0.8%]; p = 0.12). CONCLUSIONS: 
      Complete FFR-guided revascularization in patients with STEMI and multivessel 
      disease did not affect final infarct size, LV function, or remodeling compared 
      with culprit-only PCI.
CI  - Copyright (c) 2019 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Kyhl, Kasper
AU  - Kyhl K
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. Electronic 
      address: kasperkyhl@gmail.com.
FAU - Ahtarovski, Kiril Aleksov
AU  - Ahtarovski KA
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Nepper-Christensen, Lars
AU  - Nepper-Christensen L
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Ekstrom, Kathrine
AU  - Ekstrom K
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Ghotbi, Adam Ali
AU  - Ghotbi AA
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Schoos, Mikkel
AU  - Schoos M
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Goransson, Christoffer
AU  - Goransson C
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Bertelsen, Litten
AU  - Bertelsen L
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Helqvist, Steffen
AU  - Helqvist S
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Holmvang, Lene
AU  - Holmvang L
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Jorgensen, Erik
AU  - Jorgensen E
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Pedersen, Frants
AU  - Pedersen F
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Saunamaki, Kari
AU  - Saunamaki K
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Clemmensen, Peter
AU  - Clemmensen P
AD  - Department of Medicine, Nykoebing F Hospital, Nykoebing F and University of 
      Southern Denmark, Odense, Denmark; University Clinic of Hamburg-Eppendorf, The 
      Heart Centre, Hamburg, Germany.
FAU - De Backer, Ole
AU  - De Backer O
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Hofsten, Dan Eik
AU  - Hofsten DE
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Kober, Lars
AU  - Kober L
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
FAU - Kelbaek, Henning
AU  - Kelbaek H
AD  - Department of Cardiology, Zealand University, Roskilde, Denmark.
FAU - Vejlstrup, Niels
AU  - Vejlstrup N
AD  - Department of Cardiology, Zealand University, Roskilde, Denmark.
FAU - Lonborg, Jacob
AU  - Lonborg J
AD  - Department of Cardiology, Zealand University, Roskilde, Denmark.
FAU - Engstrom, Thomas
AU  - Engstrom T
AD  - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark; Department of 
      Cardiology, University of Lund, Lund, Sweden.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JACC Cardiovasc Interv
JT  - JACC. Cardiovascular interventions
JID - 101467004
SB  - IM
CIN - JACC Cardiovasc Interv. 2019 Apr 22;12(8):731-733. PMID: 31000011
CIN - Ann Transl Med. 2019 Dec;7(Suppl 8):S331. PMID: 32016049
MH  - Aged
MH  - Coronary Angiography
MH  - Coronary Artery Disease/diagnostic imaging/mortality/physiopathology/*therapy
MH  - Denmark
MH  - Female
MH  - Fractional Flow Reserve, Myocardial
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Predictive Value of Tests
MH  - Recovery of Function
MH  - ST Elevation Myocardial Infarction/diagnostic 
      imaging/mortality/physiopathology/*therapy
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
MH  - Ventricular Remodeling
OTO - NOTNLM
OT  - ST-segment elevation myocardial infarction
OT  - acute myocardial infarction
OT  - cardiac function
OT  - cardiac remodeling
OT  - cardiovascular magnetic resonance
OT  - complete revascularization
OT  - culprit lesion
OT  - primary percutaneous coronary intervention
OT  - randomization
OT  - randomized study
EDAT- 2019/04/20 06:00
MHDA- 2020/06/09 06:00
CRDT- 2019/04/20 06:00
PHST- 2018/10/01 00:00 [received]
PHST- 2019/01/25 00:00 [revised]
PHST- 2019/01/29 00:00 [accepted]
PHST- 2019/04/20 06:00 [entrez]
PHST- 2019/04/20 06:00 [pubmed]
PHST- 2020/06/09 06:00 [medline]
AID - S1936-8798(19)30572-2 [pii]
AID - 10.1016/j.jcin.2019.01.248 [doi]
PST - ppublish
SO  - JACC Cardiovasc Interv. 2019 Apr 22;12(8):721-730. doi: 
      10.1016/j.jcin.2019.01.248.