@article {Dimitriu-Leene000541, author = {Aukelien C Dimitriu-Leen and Maaike P J Hermans and Caroline E Veltman and Bas L van der Hoeven and Alexander R van Rosendael and Erik W van Zwet and Martin J Schalij and Victoria Delgado and Jeroen J Bax and Arthur J H A Scholte}, title = {Prognosis of complete versus incomplete revascularisation of patients with STEMI with multivessel coronary artery disease: an observational study}, volume = {4}, number = {1}, elocation-id = {e000541}, year = {2017}, doi = {10.1136/openhrt-2016-000541}, publisher = {Archives of Disease in childhood}, abstract = {Objective The best strategy in patients with acute ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease (CAD) regarding completeness of revascularisation of the non-culprit lesion(s) is still unclear. To establish which strategy should be followed, survival rates over a longer period should be evaluated. The aim of this study was to investigate whether complete revascularisation, compared with incomplete revascularisation, is associated with reduced short-term and long-term all-cause mortality in patients with first STEMI and multivessel CAD.Methods This retrospective study consisted of 518 patients with first STEMI with multivessel CAD. Complete revascularisation (45\%) was defined as the treatment of any significant coronary artery stenosis (>=70\% luminal narrowing) during primary or staged percutaneous coronary intervention prior to discharge. The primary end point was all-cause mortality.Results Incomplete revascularisation was not independently associated with 30-day all-cause mortality in patients with acute first STEMI and multivessel CAD (OR 1.98; 95\% CI 0.62to6.37; p=0.25). During a median long-term follow-up of 6.7 years, patients with STEMI with multivessel CAD and incomplete revascularisation showed higher mortality rates compared with patients who received complete revascularisation (24\% vs 12\%, p\<0.001), and these differences remained after excluding the first 30 days. However, in multivariate analysis, incomplete revascularisation was not independently associated with increased all-cause mortality during long-term follow-up in the group of patients with STEMI who survived the first 30 days post-STEMI (HR 1.53 95\% CI 0.89-2.61, p=0.12).Conclusion In patients with acute first STEMI and multivessel CAD, incomplete revascularisation compared with complete revascularisation was not independently associated with increased short-term and long-term all-cause mortality.}, URL = {https://openheart.bmj.com/content/4/1/e000541}, eprint = {https://openheart.bmj.com/content/4/1/e000541.full.pdf}, journal = {Open Heart} }