{"id":"5459bff62c1c","type":"article","url":"https://hartvaat.nl/2019/12/03/timing-van-non-culprit-revascularisatie-bij-stemi-complete-trial/","title":"Timing van non-culprit revascularisatie bij STEMI: COMPLETE-trial","title_en":"Timing of Staged Nonculprit Artery Revascularization in Patients With ST-Segment Elevation Myocardial Infarction: COMPLETE Trial.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2019.09.051","source_url":"https://doi.org/10.1016/j.jacc.2019.09.051","authors":["David A Wood","John A Cairns","Jia Wang","Roxana Mehran","Robert F Storey","Helen Nguyen","Brandi Meeks","Vijay Kunadian","Jean-Francois Tanguay","Hahn-Ho Kim","Asim Cheema","Payam Dehghani","Madhu K Natarajan","Sanjit S Jolly","John Amerena","Matyas Keltai","Stefan James","Ota Hlinomaz","Kari Niemela","Khalid AlHabib","Basil S Lewis","Michel Nguyen","Jaydeep Sarma","Vladimir Dzavik","Anthony Della Siega","Shamir R Mehta"],"significance":7,"published":"2019-12-03","source_date":"2019-12-03","image":"","kennis":[],"congress":"","summary_en":"This COMPLETE subanalysis examined the optimal timing of staged nonculprit revascularization in STEMI, finding that both early (during index hospitalization) and later (within 45 days) timing provided similar clinical benefit.","created":"2026-07-03T10:28:19Z","updated":"2026-07-03T13:27:29Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"COMPLETE subanalyse naar de optimale timing van non-culprit revascularisatie bij STEMI met multivatenlijden.","abstract_original":"BACKGROUND: The COMPLETE (Complete vs Culprit-only Revascularization to Treat Multi-vessel Disease After Early PCI for STEMI) trial demonstrated that staged nonculprit lesion percutaneous coronary intervention (PCI) reduced major cardiovascular (CV) events in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (CAD). OBJECTIVES: The purpose of this study was to determine the effect of nonculprit-lesion PCI timing on major CV outcomes and also the time course of the benefit of complete revascularization. METHODS: Following culprit-lesion PCI, 4,041 patients with STEMI and multivessel CAD were randomized to staged nonculprit-lesion PCI or culprit-lesion only PCI. Randomization was stratified according to investigator-planned timing of nonculprit-lesion PCI: during or after the index hospitalization. The first coprimary outcome was the composite of CV death or myocardial infarction (MI). In pre-specified analyses, hazard ratios (HRs) were calculated for each time stratum. Landmark analyses of the entire population were performed within 45 days and after 45 days. RESULTS: For nonculprit-lesion PCI planned during the index hospitalization (actual time: median 1 day), CV death or MI was reduced with complete revascularization compared with culprit-lesion only PCI (HR: 0.77; 95% confidence interval [CI]: 0.59 to 1.00). For nonculprit lesion PCI planned to occur after hospital discharge (actual time: median 23 days), CV death or MI was also reduced with complete revascularization (HR: 0.69; 95% CI: 0.49 to 0.97; interaction p = 0.62). Landmark analyses demonstrated an HR of 0.86 (95% CI: 0.59 to 1.24) during the first 45 days and 0.69 (95% CI: 0.54 to 0.89) from 45 days to the end of follow-up for intended nonculprit lesion PCI versus culprit lesion only PCI. CONCLUSIONS: Among STEMI patients with multivessel disease, the benefit of complete revascularization over culprit-lesion only PCI was consistent irrespective of the investigator-determined timing of nonculprit-lesion intervention. The benefit of complete revascularization on hard clinical outcomes emerged mainly over the long term."}