AUTHOR=Lim Yongwhan , Jang Jaehyuk , Lee Seung Hun , Ahn Joon Ho , Hong Young Joon , Ahn Youngkeun , Jeong Myung Ho , Kim Chan Joon , Hahn Joo-Yong , Lee Joo Myung , Park Keun Ho , Choo Eun Ho , Ahn Sung Gyun , Doh Joon-Hyung , Lee Sang Yeub , Park Sang Don , Lee Hyun-Jong , Kang Min Gyu , Cho Yun-Kyeong , Nam Chang Wook , Bu Sung Hyun , Kim Min Chul 

TITLE=Staged versus immediate complete revascularization for non-culprit arteries in acute myocardial infarction: a post-hoc analysis of FRAME-AMI

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1475483

DOI=10.3389/fcvm.2024.1475483

ISSN=2297-055X

ABSTRACT=Background and objectivesThe optimal timing for complete revascularization (CR) in patients with acute myocardial infarction (AMI) and multivessel disease (MVD) remain uncertain.MethodsThis post-hoc analysis of the FRAME-AMI trial included AMI patients with MVD (n = 549). They were classified into immediate (n = 329) and staged CR (n = 220) groups. All percutaneous coronary interventions were performed during inex hospitalization. The primary endpoint was a composite of all-cause death, acute myocardial infarction, and repeated revascularization. Secondary endpoints included each component of the primary endpoint. Additional comparisons for the outcomes in ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) were also performed.ResultsThe incidence of the primary endpoint was not significantly different in any of the AMI patients [12.7% [immediate CR] vs. 17.4% [staged CR], p = 0.905, adjusted hazard ratio [HR] of staged CR = 0.81, 95% confidence interval = 0.43–1.53, p = 0.528]. Other secondary endpoints were also not significantly different. Analyses of STEMI and Neither the primary or secondary endpoints of NSTEMI patients were significantly different.ConclusionsIn this post-hoc analysis of the FRAME-AMI trial, no significant difference in clinical outcomes was observed between the immediate and staged CR strategies for AMI with MVD and the subgroups, such as STEMI or NSTEMI. However, the results should be interpreted carefully because of the many limitations, including a limited sample size and a lack of statistical power.
Trial Registration: FRAME-AMI clinicaltrials.gov, identifier (NCT02715518).