Table 1 Summary of major clinical trials evaluation culprit only vs complete revascularization

From: Complete Revascularization in Patients With STEMI and Multivessel Coronary Artery Disease: Is It Beneficial?

Trial Year N (complete/culprit only) Revascularization approach Mean/median follow-up time Major finding Major adverse cardiac events All-cause mortality Re-infarction Urgent revascularization
PRAMI [19••] 2013 234/231 Primary PCI 24 months PCI in non-infarct coronary arteries with major stenoses significantly reduces the risk of adverse cardiovascular events, as compared with PCI limited to the infarct artery. 21/53 12/16 7/20 16/46
CvLPRIT [20••] 2015 150/146 Primary PCI (67%) – staged prior to discharge (33%) 12 months Complete revascularization is associated with an 11% absolute reduction in major adverse cardiovascular outcomes (MACE) at 12 months compared to culprit lesion-only revascularization, driven by symmetric modest reductions in each component of the primary composite outcome. 15/31 2/6 0/2 7/12
DANAMI-3-PRIMULTI [23••] 2015 314/313 Staged 2 days after primary PCI 27 months FFR-guided complete revascularization is associated with a 9% absolute reduction in major cardiovascular adverse events (death, MI, revascularization) at 27 months. 40/68 15/11 15/16 17/52
COMPARE-ACUTE [24••] 2017 295/590 Primary PCI (83%) – staged prior to discharge (17%) 12 months FFR-guided complete revascularization
is associated with a 12.7% absolute reduction in major cardiovascular adverse events (death, MI, revascularization, stroke)
23/121 4/10 7/28 18/103
COMPLETE [25••] 2019 2016/2025 Staged: Prior to discharge (64%) – within 45 days (36%) 3 years Complete revascularization was superior to culprit-lesion-only PCI in reducing the risk of cardiovascular death or myocardial infarction, as well as the risk of cardiovascular death, myocardial infarction, or ischemia-driven revascularization 179/339 96/106 109/160 29/160
CULPRIT-SHOCK [26] 2017 341/344 Primary PCI (91%) – staged (2.3%) 30 days In patient with shock 30-day risk of a composite of death or severe renal failure leading to renal-replacement therapy in lower among those who initially underwent PCI of the culprit lesion only 189/158 176/149 3/4 13/74
EXPLORE [27••] 2016 150/154 Early PCI of the CTO (49.3%) – conservative (50.7%) 4 months In CTO patients, no benefit in LVEF or LVEDV with complete revascularization