ESC 23 — Prof Barbara Stähli (University Hospital Zurich, CH) joins us onsite at ESC 23 to outline the findings of the MULTISTARS AMI Trial (NCT03135275).

MULTISTARS AMI aimed to compare the safety and efficacy of two treatment strategies currently performed in clinical practice, immediate complete revascularization versus staged complete revascularization in patients presenting with ST-elevation myocardial infarction (STEMI) and multivessel disease (MVD). Patients randomized to receive staged complete revascularization will have only the culprit lesion treated. 840 participants were enrolled in the trial.

Results suggest that immediate PCI of non-culprit lesions is non-inferior to staged multivessel PCI for reducing death and ischemic events in patients with STEMI and multivessel CAD. These results were found to be generally consistent across prespecified key subgroups, including women and men, younger and older patients and patients with or without diabetes.

Questions:

1. What is the importance of this trial?
2. What are the benefits linked with each strategy?
3. What was the study design, eligibility criteria and outcome measures?
4. What are the key findings presented at ESC?
5. How should these findings inform practice?
6. What are the remaining questions? What are the next steps?

Recorded on-site at ESC Congress 2023, Amsterdam. 

Editors: Mirjam Boros and Jordan Rance

Video Specialists: Dan Brent, Tom Green, Mike Knight, Oliver Miles