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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1475483

Staged versus Immediate Complete Revascularization for Non-culprit Arteries in Acute Myocardial Infarction: A Post-hoc Analysis of FRAME-AMI

Provisionally accepted
Yongwhan Lim Yongwhan Lim 1Jaehyuk Jang Jaehyuk Jang 2Seung Hun Lee Seung Hun Lee 1Joon Ho Ahn Joon Ho Ahn 1Young Joon Hong Young Joon Hong 1Youngkeun Ahn Youngkeun Ahn 1Myung Ho Jeong Myung Ho Jeong 1Chan Joon Kim Chan Joon Kim 2Joo-Yong Hahn Joo-Yong Hahn 3Joo Myung Lee Joo Myung Lee 3Keun Ho Park Keun Ho Park 4Eun Ho Choo Eun Ho Choo 5Sung Gyun Ahn Sung Gyun Ahn 6Joon-Hyung Doh Joon-Hyung Doh 7Sang Yeub Lee Sang Yeub Lee 8Sang Don Park Sang Don Park 9Hyun-Jong Lee Hyun-Jong Lee 10Min Gyu Kang Min Gyu Kang 11Yun-Kyeong Cho Yun-Kyeong Cho 12Chang Wook Nam Chang Wook Nam 13Hyun Hyun Bu Hyun Hyun Bu 2Min Chul Kim Min Chul Kim 1*
  • 1 Chonnam National University Medical School, Gwangju, Republic of Korea
  • 2 Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea
  • 3 Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
  • 4 Chosun University Hospital, Gwangju, Republic of Korea
  • 5 Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Seoul, Republic of Korea
  • 6 Wonju College of Medicine, Yonsei University, Wonju, Gangwon, Republic of Korea
  • 7 Inje University Ilsan Paik Hospital, Goyang-si, Republic of Korea
  • 8 Chung-Ang University Gwangmyeong Hospital, Gwangmyeonsi, Gyeonggi, Republic of Korea
  • 9 Inha University Hospital, Incheon, Republic of Korea
  • 10 Sejong General Hospital, Bucheon-si, Republic of Korea
  • 11 College of Medicine, Gyeongsang National University, Jinju, South Gyeongsang, Republic of Korea
  • 12 Keimyung University Dongsan Medical Center, Daegu, North Gyeongsang, Republic of Korea
  • 13 Keimyung University Dongsan Hospital, Daegu, North Gyeongsang, Republic of Korea

The final, formatted version of the article will be published soon.

    The optimal timing for complete revascularization (CR) in patients with acute myocardial infarction (AMI) and multivessel disease (MVD) remain uncertain.This 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.The 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.In 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.

    Keywords: acute myocardial infarction1, multivessel disease2, staged complete revascularization3, immediate complete revascularization4, FRAME-AMI5 FRAME-AMI ClinicalTrials.gov number, NCT02715518

    Received: 04 Aug 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Lim, Jang, Lee, Ahn, Hong, Ahn, Jeong, Kim, Hahn, Lee, Park, Choo, Ahn, Doh, Lee, Park, Lee, Kang, Cho, Nam, Bu and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Min Chul Kim, Chonnam National University Medical School, Gwangju, Republic of Korea

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