Which One Should be Treated in the Setting of Acute ST Elevation Myocardial Infarction - Culprit Lesion or Culprit Vessel?
1 other identifier
observational
637
0 countries
N/A
Brief Summary
The current guidelines still recommend emergent PCI of the culprit lesion and state that primary PCI should be limited to the culprit vessel with the exception of cardiogenic shock and persistent ischaemia after PCI of the supposed culprit lesion. This recommendation is based on a high number of studies. However, several studies are present about the safety and efficacy of non-culprit vessel PCI during acute MI. Nowadays, the debate is increasingly going on about the PCI of the non-culprit arteries during the index event with newer prospective randomized studies. Besides, it is still unclear for the culprit artery whether to treat only the culprit lesion or all the other lesions in the culprit vessel during the index event. The present report describes a retrospective comparison between the two strategies during primary PCI for STEMI, looking for their influence on the clinical and angiographic course of the patients.
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Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
June 1, 2014
CompletedFirst Submitted
Initial submission to the registry
February 1, 2015
CompletedPrimary Completion
Last participant's last visit for primary outcome
February 1, 2015
CompletedFirst Posted
Study publicly available on registry
February 5, 2015
CompletedFebruary 5, 2015
February 1, 2015
8 months
February 1, 2015
February 4, 2015
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
MACE
18 months
Study Arms (2)
Culprit lesion
Patients who underwent culprit lesion only PCI during primary intervention
Culprit vessel
Patients who underwent culprit lesion only PCI during primary intervention
Interventions
Eligibility Criteria
This multi-centre retrospective study included patients from 3 high-volume primary PCI centres in Turkey. A total number of 5512 patients underwent emergent PCI for acute STEMI between January 2011 and December 2013. From this patient population, patients were looked for the presence of an additional lesion to the culprit lesion (CL). Additional lesion was defined as the presence of an angiographically severe (≥70%) lesion other than the CL either proximal or distal to it in the same coronary artery after the distal flow was observed most commonly as a result of guide-wire passage or PTCA of the total occlusion.
You may qualify if:
- Patients who underwent primary PCI for acute STEMI and had \>1 lesion in the culprit artery
You may not qualify if:
- Presence of LMCA lesion
- Cardiogenic shock
- Previous CABG operation
- Decision for CABG operation after primary PCI
- Severe valvular disease including aortic stenosis of mitral insufficiency
- Severe kidney disease (serum creatinine \>2.5 mg/dl or patients on maintenance hemodialysis)
- Rejection of second PCI by the patient after the index event
Contact the study team to confirm eligibility.
Sponsors & Collaborators
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Design
- Study Type
- observational
- Observational Model
- COHORT
- Time Perspective
- RETROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Associate Proffessor of Cardiology, Head of Department
Study Record Dates
First Submitted
February 1, 2015
First Posted
February 5, 2015
Study Start
June 1, 2014
Primary Completion
February 1, 2015
Last Updated
February 5, 2015
Record last verified: 2015-02