At present, the two treatment strategies of opening non infarct related arteries (non IRA) simultaneously or by stages after emergency percutaneous coronary intervention (PCI) in patients with acute ST segment elevation myocardial infarction (STEMI) complicated with multi vessel disease (MVD) are still controversial. In our previous retrospective analysis, there was no significant difference between complete revascularization (CR) and staged CR at Anzhen Hospital in the cases of cardiac death, reinfarction, stroke, proportion of revascularization and hospitalization rate of heart failure.
The literature reports on the benefits of two CR strategies of opening non IRA simultaneously or by stages after IRA treatment in STEMI patients are inconsistent. This study intends to enroll 426 cases and divide into two groups to verify whether the occurrence of major cardiovascular adverse events (all-cause death, nonfatal myocardial infarction, ischemia driven revascularization and heart failure) in one year in immediately open non-IRA after successful emergency PCI of infarct related arteries in STEMI patients with MVD group is not inferior to staged (within 45 days) CR group. It can accumulate more evidence-based medical basis for the selection of better treatment schemes, so as to formulate optimized treatment schemes for clinic. To study when to open meaningful non IRA in acute STEMI complicated with MVD is of great guiding significance for CR after acute myocardial infarction. At the same time, it has important social significance and economic value for delaying or preventing cardiovascular events.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
426
Immediately opening non-IRA after emergency opening IRA in STEMI patients with MVD
Staged opening non-IRA after emergency opening IRA in STEMI patients with MVD
Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University
Beijing, Beijing Municipality, China
Major Adverse Cardiovascular Event
Including All-cause death, Ischemia driven revascularization, Nonfatal myocardial infarction and Heart failure
Time frame: 1 year
All-cause death
All reasons of death
Time frame: 1 year
Ischemia driven revascularization
Myocardial ischemia needs to revascularize
Time frame: 1 year
Nonfatal myocardial infarction
A kind of Myocardial infarction which does not lead to death
Time frame: 1 year
Heart failure
Deterioration of heart function or acute heart failure
Time frame: 1 year
Cardiovascular related death
Died of cardiovascular diseases
Time frame: 1 year
Stent thrombosis
Thrombosis in stent
Time frame: 1 year
Dialysis or acute renal insufficiency
Dialysis or acute renal insufficiency occurred after operation
Time frame: 1 year
Bleeding events
Bleeding occurred after oral administration of dual antiplatelet drugs
Time frame: 1 year
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