QOL Improves With Complete Revascularization After STEMI
The trial enrolled 4041 patients with STEMI and multivessel disease who had undergone successful PCI of the culprit lesion but were found to have nonculprit lesions of at least 70% or a fractional flow reserve measurement of 0.80. Patients were then randomly assigned to complete revascularization of any additional angiographically significant nonculprit lesions or to no further revascularization. Among those allocated to intervention, 122 crossed over to culprit-lesion-only revascularization.

SAQ data were collected at baseline, 6 months, and study end, with final data available from 86.8% of the complete revascularization group and 85.0% of the culprit-only group. Mean age of the study participants was 62 years, 19% were female, and 19% had diabetes.

At baseline, 12% of patients reported weekly or daily angina but, importantly, 50% had no self-reported history of angina, Mehta pointed out. The change in SAQ scores from baseline to 6 months for the complete revascularization and culprit-only groups was as follows:
Angina frequency: 7.3 vs 6.4 (P = .039)
Physical limitation: 3.3 vs 3.3 points (P = .18)
Treatment satisfaction: 0.7 vs –0.2 points (P < .001)
Quality of life: 13.2 vs 11.5 (P < .001)
Summary score: 13.2 vs 11.5 (P < .001)
Residual stenosis was reported among patients with less than 80% nonculprit-lesion stenosis in 11% with culprit-lesion-only PCI and in 14% with complete revascularization. Among those with 80% or greater nonculprit-lesion stenosis, however, 16.8% and 12.3%, respectively, reported residual angina (P for interacti

Source: https://www.medscape.com/viewarticle/971869?src=rss
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