6/28/23, 12:29 AM CvLPRIT Pathway Feedback Search Clinical Topics Home Studies CvLPRIT CvLPRIT Disease Disease Coronary artery disease ST-elevation myocardial infarction Trial question What is the role of complete revascularization in patients presenting for primary PCI with multivessel disease? Study design Multi-center Open label RCT Population Characteristics of study participants 19.0% female N = 296 81.0% male 296 patients (56 female, 240 male) Inclusion criteria: patients found to have multivessel disease while undergoing primary PCI for ST-segment elevation myocardial infarction Key exclusion criteria: age < 18 years; clear indication for, or contraindication to, multi vessel P-PCI; previous Q wave myocardial infarction; patients with prior CABG; cardiogenic shock; VSD or moderate/severe MR; CKD; suspected or confirmed thrombosis of a previously stented artery Interventions N=150 complete percutaneous coronary revascularization (including all non-infarct-related arteries) N=146 IRA-only percutaneous coronary revascularization (infarct related artery only) Primary outcome https://web.pathway.md/studies/recqIXBtnnEB9qUWL 1/2 6/28/23, 12:29 AM CvLPRIT Pathway Rate of all-cause death, recurrent myocardial infarction, heart failure, and ischemia-driven revascularization within 12 months 21.2 % 21.2 15.9 % 10.6 % 10 Significant decrease 5.3 % NNT = 9 0.0 % Complete percutaneous coronary revascularization IRA-only percutaneous coronary revascularization Significant decrease in the rate of all-cause death, recurrent myocardial infarction, HF, and ischemia-driven revascularization within 12 months (10% vs. 21.2%; HR 0.45, 95% CI 0.24 to 0.84) Secondary outcomes No significant difference in death from any cause at 12 months (1.3% vs. 4.1%; HR 0.32, 95% CI 0.06 to 1.6) No significant difference in recurrent MI at 12 months (1.3% vs. 2.7%; HR 0.48, 95% CI 0.09 to 2.62) No significant difference in repeat revascularization at 12 months (4.7% vs. 8.2%; HR 0.55, 95% CI 0.22 to 1.39) Safety outcomes No significant differences in stroke, major bleeding, or contrast-induced nephropathy. Conclusion In patients found to have multivessel disease while undergoing primary PCI for ST-segment elevation myocardial infarction, complete percutaneous coronary revascularization was superior to IRA-only percutaneous coronary revascularization with respect to the rate of all-cause death, recurrent myocardial infarction, HF, and ischemia-driven revascularization within 12 months. Reference Gershlick AH, Khan JN, Kelly DJ et al. Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial. J Am Coll Cardiol. 2015 Mar 17;65(10):963-72. Open reference URL https://web.pathway.md/studies/recqIXBtnnEB9qUWL 2/2