What is the evidence to support PCI in a noninfarct artery at a separate time from primary PCI in patients with intermediate- or high-risk findings on noninvasive tests?
Studies of staged PCI of noninfarct arteries have been nonrandomized in design and have varied with regard to the timing of PCI and duration of follow-up. These variations have contributed to the disparate findings reported, although there seems to be a clear trend toward lower rates of adverse outcomes when primary PCI is limited to the infarct artery and PCI of a noninfarct artery is undertaken in staged fashion at a later time.216,224,225,383,384 The largest of these observational studies compared 538 patients undergoing staged multivessel PCI within 60 days of primary PCI with propensity-matched individuals who had culprit-vessel PCI Multivessel PCI was associated with a lower mortality rate at 1 year (1.3% versus 3.3%; P=0.04).A nonsignificant trend toward a lower mortality rate at 1 year was observed in the subset of 258 patients who underwent staged PCI during the initial Table 10.