Rationale and design of the MULTISTARS AMI Trial: a randomized comparison of immediate versus staged complete revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease

Stähli, B. E. et al. (2020) Rationale and design of the MULTISTARS AMI Trial: a randomized comparison of immediate versus staged complete revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease. American Heart Journal, 228, pp. 98-108. (doi: 10.1016/j.ahj.2020.07.016) (PMID:32871329)

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Abstract

Background: About half of patients with acute ST-segment elevation myocardial infarction (STEMI) present with multivessel coronary artery disease (MVD). Recent evidence supports complete revascularization in these patients. However, optimal timing of non-culprit lesion revascularization in STEMI patients is unknown because dedicated randomized trials on this topic are lacking. Study design: The MULTISTARS AMI trial is a prospective, international, multicenter, randomized, two-arm, open-label study planning to enroll at least 840 patients. It is designed to investigate whether immediate complete revascularization is non-inferior to staged (within 19-45 days) complete revascularization in patients in stable hemodynamic conditions presenting with STEMI and MVD and undergoing primary percutaneous coronary intervention (PCI). After successful primary PCI of the culprit artery, patients are randomized in a 1:1 ratio to immediate or staged complete revascularization. The primary endpoint is a composite of all-cause death, non-fatal myocardial infarction, ischemia-driven revascularization, hospitalization for heart failure, and stroke at 1 year. Conclusions: The MULTISTARS AMI trial tests the hypothesis that immediate complete revascularization is non-inferior to staged complete revascularization in stable patients with STEMI and MVD.

Item Type:Articles
Additional Information:MULTISTARS AMI is funded by the Investigator-Sponsored Research Program of Boston Scientific Corporation (Marlborough, MA, USA; grant number ISROTH10277).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ford, Professor Ian
Authors: Stähli, B. E., Varbella, F., Schwarz, B., Nordbeck, P., Felix, S. B., Lang, I. M., Toma, A., Moccetti, M., Valina, C., Vercellino, M., Rigopoulos, A. G., Rohla, M., Schindler, M., Wischnewsky, M., Linke, A., Schulze, P. C., Richardt, G., Laugwitz, K.-L., Weidinger, F., Rottbauer, W., Achenbach, S., Huber, K., Neumann, F.-J., Kastrati, A., Ford, I., Ruschitzka, F., and Maier, W.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:American Heart Journal
Publisher:Elsevier
ISSN:0002-8703
ISSN (Online):1097-6744
Published Online:30 July 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in American Heart Journal 228: 98-108
Publisher Policy:Reproduced under a Creative Commons License

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