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 BE, Varbella F, Schwarz B, Nordbeck P, Felix SB, Lang IM, Toma A, Moccetti M, Valina C, Vercellino M, Rigopoulos AG, Rohla M, Schindler M, Wischnewsky M, Linke A, Schulze PC, Richardt G, Laugwitz KL, Weidinger F, Rottbauer W, Achenbach S, Huber K, Neumann FJ, Kastrati A, Ford I, Ruschitzka F, Maier W (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Book Volume: 228

Pages Range: 98-108

DOI: 10.1016/j.ahj.2020.07.016

Abstract

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.

Authors with CRIS profile

Involved external institutions

Azienda Ospedaliera Nazionale SS.Antonio e Biagio e C.Arrigo Italy (IT) Universitätsmedizin Greifswald / Universitätsklinikum Greifswald Germany (DE) Cardiocentro Ticino Switzerland (CH) Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH Germany (DE) Medizinische Universität Wien Austria (AT) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Universitätsspital Zürich (USZ) Switzerland (CH) Universitätsklinikum Würzburg Germany (DE) Universitätsklinikum Halle (Saale) Germany (DE) Universitätsklinikum Jena Germany (DE) University of Glasgow United Kingdom (GB) Krankenanstalt Rudolfstiftung Austria (AT) Universitätsklinikum Ulm Germany (DE) Deutsches Herzzentrum München Germany (DE) Klinikum rechts der Isar Germany (DE) Universität Bremen Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Sigmund-Freud-Privatuniversität Wien (SFU) / Sigmund Freud University Austria (AT)

How to cite

APA:

Stähli, B.E., Varbella, F., Schwarz, B., Nordbeck, P., Felix, S.B., Lang, I.M.,... Maier, W. (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, 98-108. https://doi.org/10.1016/j.ahj.2020.07.016

MLA:

Stähli, Barbara E., et al. "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 (2020): 98-108.

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