Single-Staged Compared With Multi-Staged PCI in Multivessel NSTEMI Patients

Sardella, Gennaro; Lucisano, Luigi; Garbo, Roberto; Pennacchi, Mauro; Cavallo, Erika; Stio, Rocco Edoardo; Calcagno, Simone; Ugo, Fabrizio; Boccuzzi, Giacomo; Fedele, Francesco; Mancone, Massimo

doi:10.1016/j.jacc.2015.10.082

Cited by 168Coronary Interventions and DiagnosticsAcute Myocardial Infarction ResearchCardiac Imaging and Diagnostics

Single-Staged Compared With Multi-Staged PCI in Multivessel NSTEMI Patients

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Sardella, Gennaro, Lucisano, Luigi, Garbo, Roberto, Pennacchi, Mauro, Cavallo, Erika, Stio, Rocco Edoardo, Calcagno, Simone, Ugo, Fabrizio +3 more·2016·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2015.10.082

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Abstract

Background A lack of clarity exists about the role of complete coronary revascularization in patients presenting with non-ST-segment elevation myocardial infarction.Objectives The aim of our study was to compare long-term outcomes in terms of major adverse cardiovascular and cerebrovascular events of 2 different complete coronary revascularization strategies in patients with non-ST-segment elevation myocardial infarction and multivessel coronary artery disease: 1-stage percutaneous coronary intervention (1S-PCI) during the index procedure versus multistage percutaneous coronary intervention (MS-PCI) complete coronary revascularization during the index hospitalization.Methods In the SMILE (Impact of Different Treatment in Multivessel Non ST Elevation Myocardial Infarction Patients: One Stage Versus Multistaged Percutaneous Coronary Intervention) trial, 584 patients were randomly assigned in a 1:1 manner to 1S-PCI or MS-PCI. The primary study endpoint was the incidence of major adverse cardiovascular and cerebrovascular events, which were defined as cardiac death, death, reinfarction, rehospitalization for unstable angina, repeat coronary revascularization (target vessel revascularization), and stroke at 1 year.Results The occurrence of the primary endpoint was significantly lower in the 1-stage group (1S-PCI: n = 36 [13.63%] vs. MS-PCI: n = 61 [23.19%]; hazard ratio [HR]: 0.549 [95% confidence interval (CI): 0.363 to 0.828]; p = 0.004). The 1-year rate of target vessel revascularization was significantly higher in the MS-PCI group (1S-PCI: n = 22 [8.33%] vs. MS-PCI: n = 40 [15.20%]; HR: 0.522 [95% CI: 0.310 to 0.878]; p = 0.01; p log-rank = 0.013). When the analyses were limited to cardiac death (1S-PCI: n = 9 [3.41%] vs. MS-PCI: n = 14 [5.32%]; HR: 0.624 [95% CI: 0.270 to 1.441]; p = 0.27) and myocardial infarction (1S-PCI: n = 7 [2.65%] vs. MS-PCI: n = 10 [3.80%]; HR: 0.678 [95% CI: 0.156 to 2.657]; p = 0.46), no significant differences were observed between groups.Conclusions In multivessel non-ST-segment elevation myocardial infarction patients, complete 1-stage coronary revascularization is superior to multistage PCI in terms of major adverse cardiovascular and cerebrovascular events. (Impact of Different Treatment in Multivessel Non ST Elevation Myocardial Infarction [NSTEMI]Patients One Stage Versus Multistaged Percutaneous Coronary Intervention [PCI] [SMILE]: NCT01478984).

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Diabetes is a frequent comorbidity in patients hospitalized for ACS, with an increasing prevalence over the last decade and a high mortality rate.
“Diabetes is a frequent comorbidity in patients hospitalized for ACS, with an increasing prevalence over the last decade and a high mortality rate.409”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [409]

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Kim, M. C., Hyun, J. Y., Ahn, Y., Bae, S., Hyun, D. Y., Cho, K. H., Sim, D. S., Hong, Y. J., Kim, J. H., Jeong, M. H., et al. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.120.016575 · Cited by 40 · see citing works
Culprit Lesion Detection in Patients Presenting With Non-ST Elevation Acute Coronary Syndrome and Multivessel Disease
Balbi, M. M., Scarparo, P., Tovar, M. N., Masdjedi, K., Daemen, J., den Dekker, W. K., Ligthart, J. M. R., Witberg, K. T., Cummins, P. A., Wilschut, J., et al. (2021) · Cardiovascular revascularization medicine · doi:10.1016/j.carrev.2021.03.019 · Cited by 43 · see citing works
Percutaneous coronary intervention strategies in patients with acute myocardial infarction and multivessel disease: Completeness, timing, lesion assessment, and patient status
Saito, Y., & Kobayashi, Y. (2019) · Journal of Cardiology · doi:10.1016/j.jjcc.2019.04.001 · Cited by 33 · see citing works
Optimal Timing of Complete Revascularization in Acute Coronary Syndrome: A Systematic Review and Meta‐Analysis
Gaffar, R., Habib, B., Filion, K. B., Reynier, P., & Eisenberg, M. J. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.116.005381 · Cited by 30 · see citing works
“revascularization in STEMI patients and recommended revascularization of nonculprit lesions at a later date only if clinically indicated.(1,2) However, several meta-analyses have found multivessel revascularization to be superior to culprit-only revascularization for outcomes such as unplanned repeat revascularization…”
Background
Differences in the 2020 ESC Versus 2015 ESC and 2014 ACC/AHA Guidelines on the Management of Acute Coronary Syndromes in Patients Presenting Without Persistent ST-Segment Elevation
Keykhaei, M., Ashraf, H., Rashedi, S., Farrokhpour, H., Heidari, B., Zokaei, S., Bagheri, S., Foroumadi, R., Asgarian, S., Amirian, A., et al. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00976-7 · Cited by 28 · see citing works
Guía ESC 2020 sobre el diagnóstico y tratamiento del síndrome coronario agudo sin elevación del segmento ST
Collet, J., Thiele, H., Barbato, E., Barthélémy, O., Bauersachs, J. K., Bhatt, D. L., Dendale, P., Dorobanţu, M., Edvardsen, T., Folliguet, T. A., et al. (2021) · Revista Española de Cardiología · doi:10.1016/j.recesp.2020.12.024 · Cited by 28 · see citing works
Relationship Between the Fibrinogen-to-Albumin Ratio and SYNTAX Score in Patients with Non-St-Elevation Myocardial Infarction
Erdoğan, G., Arslan, U., Yenerçağ, M., Durmuş, G., Tuğrul, S., & Şahin, İ. (2021) · Revista de investigaci�n Cl�nica · doi:10.24875/ric.20000534 · Cited by 25 · see citing works
Apolipoprotein A1 is associated with SYNTAX score in patients with a non-ST segment elevation myocardial infarction
Chen, B., Chen, X.-C., Yang, Y.-N., Gao, X.-M., Ma, X., Huang, Y., Li, X.-M., Gai, M., Liu, F., Pan, S., et al. (2019) · Lipids in Health and Disease · doi:10.1186/s12944-019-1101-9 · Cited by 24 · see citing works
2021 Korean Society of Myocardial Infarction Expert Consensus Document on Revascularization for Acute Myocardial Infarction
Chang, K., Ahn, Y., Lim, S., Yang, J. H., Lee, K. Y., Choo, E. H., Kim, H. K., Nam, C., Kim, W., Hwang, J., et al. (2021) · Korean Circulation Journal · doi:10.4070/kcj.2021.0043 · Cited by 24 · see citing works
Timing of Complete Multivessel Revascularization in Patients Presenting With Non-ST-Segment Elevation Acute Coronary Syndrome
Elscot, J. J., Kakar, H., Scarparo, P., den Dekker, W. K., Bennett, J., Schotborgh, C. E., van der Schaaf, R. J., Sabaté, M., Moreno, R., Ameloot, K., et al. (2024) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2024.01.278 · Cited by 23 · see citing works
Long-term outcomes of patients with multivessel coronary artery disease presenting non-ST-segment elevation acute coronary syndromes
Desperak, P., Hawranek, M., Gąsior, P. M., Desperak, A., Lekston, A., & Gąsior, M. (2013) · Cardiology Journal · doi:10.5603/cj.a2017.0110 · Cited by 23 · see citing works
“in SMILE Trial has demonstrated that one-stage multivessel PCI is superior to postponed intervention [13].”
BackgroundMethod
Completeness, timing, and guidance of percutaneous coronary intervention for myocardial infarction and multivessel disease: a systematic review and network meta-analysis
Laudani, C., Occhipinti, G., Greco, A., Spagnolo, M., Giacoppo, D., & Capodanno, D. (2025) · EuroIntervention · doi:10.4244/eij-d-24-00814 · Cited by 22 · see citing works
Ejection Fraction Improvement Following Contemporary High-Risk Percutaneous Coronary Intervention: RESTORE EF Study Results
Wollmuth, J. R., Patel, M. P., Dahle, T. G. A., Bharadwaj, A. S., Waggoner, T. E., Chambers, J. W., Ruiz‐Rodriguez, E., Mahmud, E., Thompson, C. A., & Morris, D. L. (2022) · Journal of the Society for Cardiovascular Angiography & Interventions · doi:10.1016/j.jscai.2022.100350 · Cited by 23 · see citing works
Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease
Cho, S., Jabin, Z., Park, K. S., Kim, J., Kang, S., Kwon, S. Y., Jeong, G.-C., Song, M., Kim, J. S., Cho, J. Y., et al. (2016) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-016-3542-y · Cited by 22 · see citing works
Frontal QRS-T angle predicts syntax score in patients with non-ST elevation myocardial infarction
Erdoğan, G., Yontar, O. C., Yenerçağ, M., Gül, S., & Arslan, U. (2020) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2020.06.008 · Cited by 21 · see citing works
Complete revascularization in acute myocardial infarction: a clinical review
Saito, Y., & Kobayashi, Y. (2023) · Cardiovascular Intervention and Therapeutics · doi:10.1007/s12928-022-00907-6 · Cited by 20 · see citing works
Better Prognosis After Complete Revascularization Using Contemporary Coronary Stents in Patients With Chronic Kidney Disease
Hwang, D., Kang, J., Yang, H., Yang, S., Park, J., Han, J., Kang, H., Koo, B., & Kim, H.-S. (2019) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.119.007907 · Cited by 19 · see citing works
Bias and Loss to Follow‐Up in Cardiovascular Randomized Trials: A Systematic Review
Fong, L. C. W., Ford, T. J., da Costa, B. R., Jüni, P., & Berry, C. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.119.015361 · Cited by 19 · see citing works
Temporal trends of patients with acute coronary syndrome and multi-vessel coronary artery disease - from the ACSIS registry
Shiyovich, A., Nir, S., Cohen, T., Iakobishvili, Z., Kornowski, R., & Eisen, A. (2020) · International Journal of Cardiology · doi:10.1016/j.ijcard.2020.01.040 · Cited by 19 · see citing works
Percutaneous complete revascularization strategies using sirolimus-eluting biodegradable polymer-coated stents in patients presenting with acute coronary syndrome and multivessel disease: Rationale and design of the BIOVASC trial
den Dekker, W. K., Mieghem, N. M. V., Bennett, J., Sabaté, M., Esposito, G., van Bommel, R. J., Daemen, J., Vrolix, M., Cummins, P. A., Lenzen, M. J., et al. (2020) · American Heart Journal · doi:10.1016/j.ahj.2020.06.006 · Cited by 17 · see citing works
“Furthermore, they suggested 1-stage complete revascularization because this strategy improved the primary composite end point of clinical events at 1-year follow-up in the SMILE study.(15) Upon this background, we designed the “Percutaneous Complete Revascularization Strategies Using Sirolimus-Elut-”
MethodResult
Completeness of revascularisation in acute coronary syndrome patients with multivessel disease
Paradies, V., Waldeyer, C., Laforgia, P. L., Clemmensen, P. M., & Smits, P. C. (2021) · EuroIntervention · doi:10.4244/eij-d-20-00957 · Cited by 18 · see citing works
Optimal Strategy for Complete Revascularization in ST-Segment Elevation Myocardial Infarction and Multivessel Disease
Ueyama, H. A., Akita, K., Kiyohara, Y., Takagi, H., Briasoulis, Α., Wiley, J., Bangalore, S., Mehran, R., Stone, G. W., Kuno, T., et al. (2025) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.09.1231 · Cited by 16 · see citing works
Eurasian clinical guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)
Барбараш, О. Л., Komarov, A. L., Панченко, Е. П., Староверов, И. И., Shakhnovich, R. M., & Yavelov, I. S. (2021) · Eurasian heart journal · doi:10.38109/2225-1685-2021-4-6-59 · Cited by 16 · see citing works
“При выборе метода реваскуляризации рекомендуется использовать индекс SYNTAX и те же принципы, что используются для пациентов со стабильной ИБС [61,62,63].”
Acute coronary syndromes and multivessel coronary artery disease
Zimbardo, G., Cialdella, P., Fusco, P. D., Donahue, M. E., d’Aquino, U. M. L., Paolucci, L., Sergi, S. C., Talarico, G. P., & Calò, L. (2023) · European Heart Journal Supplements · doi:10.1093/eurheartjsupp/suad010 · Cited by 15 · see citing works
“In fact, results from the SMILE trial showed less major adverse cardiovascular and cerebrovascular events in patients undergoing single-stage coronary revascularization compared with those undergoing complete coronary revascularization in multistage PCI during the index hospitalization (HR 0.55, 95% CI 0.36–0.83, P =…”
BackgroundInfluential
Ticagrelor versus clopidogrel in acute myocardial infarction patients with multivessel disease; From Korea Acute Myocardial Infarction Registry-National Institute of Health
Ahn, J. H., Ahn, Y., Jeong, M. H., Kim, J. H., Hong, Y. J., Sim, D. S., Kim, M. C., Hwang, J., Yoon, J., Seong, I. W., et al. (2019) · Journal of Cardiology · doi:10.1016/j.jjcc.2019.11.003 · Cited by 15 · see citing works
Impact of Ticagrelor Versus Clopidogrel on Coronary Microvascular Function After Non–ST-Segment–Elevation Acute Coronary Syndrome
Xu, J., Lo, S. T., Mussap, C. J., French, J. K., Rajaratnam, R., Kadappu, K., Premawardhana, U., Nguyen, P., Juergens, C., & Leung, D. Y. (2022) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.121.011419 · Cited by 15 · see citing works
When to Achieve Complete Revascularization in Infarct-Related Cardiogenic Shock
Masiero, G., Cardaioli, F., Rodinò, G., & Tarantini, G. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11113116 · Cited by 15 · see citing works
Multivessel versus Culprit-Only Percutaneous Coronary Intervention in Patients with Non-ST-Elevation Acute Coronary Syndrome
Pustjens, T. F. S., Timmermans, M. J. C., Rasoul, S., & Hof, A. W. J. V. ’. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11206144 · Cited by 13 · see citing works
“However, it does not address whether MV-PCI is beneficial to CO-PCI at the index procedure and what the added value of haemodynamic assessment of non-culprit lesions is [28].”
Background
Immediate versus staged complete revascularization in acute coronary syndrome: A meta-analysis of randomized controlled trials
Bujak, K., Rinaldi, R., Vidal-Calés, P., Montone, R. A., Diletti, R., Gąsior, M., Crea, F., Sabaté, M., & Brugaletta, S. (2023) · International Journal of Cardiology · doi:10.1016/j.ijcard.2023.131397 · Cited by 13 · see citing works
Is Complete Revascularisation Mandated for all Patients with Multivessel Coronary Artery Disease?
Innocentiis, C. D., Zimarino, M., & Caterina, R. D. (2017) · Interventional Cardiology Reviews Research Resources · doi:10.15420/icr.2017:23:1 · Cited by 13 · see citing works
“Lower rates of major adverse cardiovascular and cerebrovascular events in the ad hoc group were documented at a 1-year follow up.(31) However, the difference was essentially driven by the higher rate of target vessel revascularisation in the multistage group.”
Result
Multivessel vs. culprit-only revascularization in patients with non-ST-elevation acute coronary syndromes and multivessel coronary disease
Correia, C., Braga, C. G., Martins, J., Arantes, C., Abreu, G., Quina, C., Salgado, A., Pereira, M. Á., Costa, J., & Marques, J. H. S. (2018) · Revista Portuguesa de Cardiologia (English Edition) · doi:10.1016/j.repce.2017.05.011 · Cited by 13 · see citing works
Management des akuten Koronarsyndroms
Buske, M., Feistritzer, H., Jobs, A., & Thiele, H. (2023) · Herz · doi:10.1007/s00059-023-05222-1 · Cited by 14 · see citing works
Culprit-Only Revascularization, Single-Setting Complete Revascularization, and Staged Complete Revascularization in Acute Myocardial Infarction: Insights From a Mixed Treatment Comparison Meta-Analysis of Randomized Trials
Maqsood, M. H., Tamis‐Holland, J. E., Rao, S. V., Stone, G. W., & Bangalore, S. (2024) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.123.013737 · Cited by 12 · see citing works
Completeness of Revascularization as a Determinant of Outcome: A Contemporary Review and Clinical Perspectives
Kwon, O., Park, D., & Park, S. (2019) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2018.12.038 · Cited by 12 · see citing works
Fractional Flow Reserve–Guided Complete vs Culprit-Only Revascularization in Non–ST-Elevation Myocardial Infarction and Multivessel Disease
Pustjens, T. F. S., Veenstra, L. F., Camaro, C., Ruiters, A. W., Lux, Á., Ruzsa, Z., Piróth, Z., Ilhan, M., Vainer, J., Gho, B. C. G., et al. (2025) · JAMA · doi:10.1001/jama.2025.16189 · Cited by 11 · see citing works
Complete revascularization versus culprit-lesion only PCI in patients with NSTEMI and multivessel disease – Design and rationale of the randomized COMPLETE-NSTEMI trial
Feistritzer, H., Jobs, A., Zeymer, U., Schneider, S., Lauten, P., Ferenc, M., Weferling, M., Brinkmann, R., Winkler, S., Landmesser, U., et al. (2025) · American Heart Journal · doi:10.1016/j.ahj.2025.04.007 · Cited by 11 · see citing works
Timing and completeness of revascularisation in acute coronary syndromes
Sanz‐Sánchez, J., & Stefanini, G. G. (2021) · Heart · doi:10.1136/heartjnl-2020-316743 · Cited by 11 · see citing works
Culprit vessel vs. immediate multivessel vs. out-of-hospital staged intervention for patients with non-ST-segment elevation myocardial infarction and multivessel disease
Wang, C., Lang, J., Zhang, J., Hu, Y., Han, C., Xu, R., Wu, J., Liu, C., Li, W., Li, T., et al. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.1033475 · Cited by 13 · see citing works
A SMILE and a Frown
Henriques, J. P. S., & Claessen, B. E. P. M. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.10.064 · Cited by 11 · see citing works
Multivessel revascularization in non-ST segment elevation acute coronary syndromes: A systematic review and meta-analysis of 182,798 patients
Bianchini, E., Basile, M., Bianchini, F., Zito, A., Romagnoli, E., Aurigemma, C., Paraggio, L., Lunardi, M., Laborante, R., Fracassi, F., et al. (2024) · International Journal of Cardiology · doi:10.1016/j.ijcard.2024.132392 · Cited by 10 · see citing works
Low Ejection Fraction Predisposes to Contrast-Induced Nephropathy after the Second Step of Staged Coronary Revascularization for Acute Myocardial Infarction: A Retrospective Observational Study
Chyrchel, M., Hałubiec, P., Łazarczyk, A., Duchnevič, O., Okarski, M. T., Gębska, M., & Surdacki, A. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9061812 · Cited by 10 · see citing works
The prognostic significance of incomplete revascularization and untreated coronary anatomy following percutaneous coronary intervention: An analysis of 6,755 patients with multivessel disease
Iqbal, M. B., Smith, R. D., Lane, R., Patel, N., Mattar, W., Kabir, T., Panoulas, V. F., Mason, M. J., Dalby, M. C. D., Grocott-Mason, R. M., et al. (2017) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.27331 · Cited by 10 · see citing works
Revascularização multivaso versus revascularização da artéria culprit em pacientes com síndrome coronária aguda sem supradesnivelamento do segmento ST e doença coronária multivaso
Correia, C., Braga, C. G., Martins, J., Arantes, C., Abreu, G., Quina, C., Salgado, A., Pereira, M. Á., Costa, J., & Marques, J. H. S. (2018) · Revista Portuguesa de Cardiologia · doi:10.1016/j.repc.2017.05.010 · Cited by 10 · see citing works
“Artéria ou ramo por revascularizar < 0,001 TC 0% (0) 0% (0) DA 12,7% (9) 26,2% (34) Cx 9,9% (7) 17,6% (23) CD 14,1% (10) 21,5% (28) Mais do que uma artéria 0% (0) 35,1% (46)”
Background
Design and rationale of ischaemia-driven complete revascularisation versus usual care in patients with non-ST-elevation myocardial infarction and multivessel coronary disease: the South Limburg Myocardial Infarction (SLIM) trial
Pustjens, T. F. S., Streukens, B., Vainer, J., Gho, B. C. G., Ruiters, A. W., Stein, M., Ilhan, M., Veenstra, L. F., Theunissen, R. A. L. J., Bekkers, S. C. A. M., et al. (2019) · Netherlands Heart Journal · doi:10.1007/s12471-019-01332-w · Cited by 10 · see citing works
Effect of Timing of Staged Percutaneous Coronary Intervention on Clinical Outcomes in Patients With Acute Coronary Syndromes
Otsuka, T., Bär, S., Losdat, S., Kavaliauskaite, R., Ueki, Y., Zanchin, C., Lanz, J., Praz, F., Häner, J. D., Siontis, G. C. M., et al. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.121.023129 · Cited by 7 · see citing works
Immediate versus staged revascularisation of non-culprit arteries in patients with acute coronary syndrome: a systematic review and meta-analysis
Vriesendorp, P. A., Wilschut, J., Diletti, R., Daemen, J., Kardys, I., Zijlstra, F., Mieghem, N. M. V., Bennett, J., Esposito, G., Sabaté, M., et al. (2022) · Netherlands Heart Journal · doi:10.1007/s12471-022-01687-7 · Cited by 9 · see citing works
Comparison of long-term outcomes of complete vs. incomplete revascularization in elderly patients (≥75 years) with acute coronary syndrome and multi-vessel disease undergoing percutaneous coronary intervention
Lu, Y., Lee, C., Chen, C., Chen, D., Ho, M.-Y., Yeh, J., Huang, Y., Chang, C.-Y., Wang, C., Chang, S., et al. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1037392 · Cited by 9 · see citing works
Revascularization Strategy in Myocardial Infarction with Multivessel Disease
Jobs, A., Desch, S., Freund, A., Feistritzer, H., & Thiele, H. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13071918 · Cited by 9 · see citing works
“The SMILE trial suggested the benefit of single-stage complete revascularization over a multi-stage approach concerning the combined endpoint of major adverse cardiovascular and cerebrovascular events [24].”
BackgroundMethod
Single-session versus staged procedures for elective multivessel percutaneous coronary intervention
Toyota, T., Morimoto, T., Shiomi, H., Yamaji, K., Andò, K., Ono, K., Shizuta, S., Saito, N., Kato, T., Kaji, S., et al. (2017) · Heart · doi:10.1136/heartjnl-2017-312117 · Cited by 9 · see citing works
Single-Session Versus Staged Multivessel Optimal IVUS-Guided PCI in Patients With CCS or NSTE-ACS
Yamamoto, K., Shiomi, H., Morimoto, T., Miyazawa, A., Watanabe, H., Nakamura, S., Suwa, S., Domei, T., Ono, K., Sakamoto, H., et al. (2023) · JACC Asia · doi:10.1016/j.jacasi.2023.03.013 · Cited by 8 · see citing works
Revascularization Strategies for Non-ST-Elevation Myocardial Infarction
George, B., Misumida, N., & Ziada, K. M. (2019) · Current Cardiology Reports · doi:10.1007/s11886-019-1125-9 · Cited by 8 · see citing works
Total versus staged versus functional revascularization in NSTEACS patients with multivessel disease
Elkady, A. O., Abdelghany, M., Diab, R., Ezz, A., & Elagha, A. (2021) · The Egyptian Heart Journal · doi:10.1186/s43044-021-00179-0 · Cited by 8 · see citing works
Association of stent diameter and target vessel revascularization in patients undergoing percutaneous coronary intervention: a secondary retrospective analysis based on a Chinese cohort study
Xu, T., Feng, B., Zheng, Z., Li, L., Zeng, W., Wang, D., Zhang, L., & Li, H. (2021) · BMC Cardiovascular Disorders · doi:10.1186/s12872-021-02212-1 · Cited by 8 · see citing works
Effect of glomerular filtration rate in patients undergoing percutaneous coronary intervention: A systematic review and meta-analysis
Zhu, X., Zhang, P., Xiong, J., Wang, N., Yang, S., Zhu, R.-L., Zhang, L., Liu, W., & Wu, L. (2022) · Medicine · doi:10.1097/md.0000000000031498 · Cited by 7 · see citing works
Multivessel vs. culprit-only percutaneous coronary intervention strategy in older adults with acute myocardial infarction
Montalto, C., Morici, N., Myat, A., Crimi, G., Luca, G. D., Bossi, I. M., de Belder, A., Savonitto, S., & Servi, S. D. (2022) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2022.09.006 · Cited by 7 · see citing works
Propensity Matched Comparison of Clinical Outcome After Immediate Versus Staged Complete Revascularization in Patients With Acute Coronary Syndrome and Multivessel Disease
Kakar, H., Elscot, J. J., Gier, A. D., Scarparo, P., Kardys, I., Nuis, R. J., Wilschut, J., den Dekker, W. K., Daemen, J., Mieghem, N. M. V., et al. (2023) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2023.05.066 · Cited by 7 · see citing works
Clinical profiles and outcomes in the treatment of acute myocardial infarction in Japan of aging society
Suzuki, M., Nishihira, K., Takegami, M., Honda, S., Kojima, S., Takayama, M., Sumiyoshi, T., Ogawa, H., Kimura, K., Yasuda, S., et al. (2020) · Heart and Vessels · doi:10.1007/s00380-020-01654-5 · Cited by 7 · see citing works
Complete Revascularization in Acute and Chronic Coronary Syndrome
Ilardi, F., Ferrone, M. L., Avvedimento, M., Servillo, G., & Gargiulo, G. (2020) · Cardiology Clinics · doi:10.1016/j.ccl.2020.06.003 · Cited by 7 · see citing works
Diagnosis, risk stratification, and early management of non-ST-segment elevation acute coronary syndrome
Kovacevic, M., Jones, D. A., Thiele, H., Steg, P. G., & Kunadian, V. (2025) · EuroIntervention · doi:10.4244/eij-d-25-00100 · Cited by 8 · see citing works
Immediate Versus Staged Complete Revascularization in Patients With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Cheema, H. A., Bhanushali, K. B., Sohail, A., Fatima, A., Hermis, A. H., Titus, A., Ahmad, A., Majmundar, V., Rehman, W. U., Sulaiman, S., et al. (2024) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2024.03.037 · Cited by 6 · see citing works
Clinical Outcomes of Immediate Versus Staged Revascularization of Nonculprit Arteries in Patients With Acute Coronary Syndrome: A Systematic Review and Meta‐Analysis
Yasmin, F., Zaidi, S. F., Moeed, A., Shahzad, M., Asghar, M. S., Sadiq, M., Iqbal, J., Surani, S., & Alraies, M. C. (2025) · Clinical Cardiology · doi:10.1002/clc.70105 · Cited by 6 · see citing works
Comparison of 30-Day MACE between Immediate versus Staged Complete Revascularization in Acute Myocardial Infarction with Multivessel Disease, and the Effect of Coronary Lesion Complexity
Doğan, C., Bayram, Z., Çap, M., Özkalaycı, F., Unkun, T., Erdoğan, E., Uslu, A., Acar, R. D., Şengör, B. G., Akbal, Ö. Y., et al. (2019) · Medicina · doi:10.3390/medicina55020051 · Cited by 6 · see citing works
Interventional treatment of acute myocardial infarction-related cardiogenic shock
Josiassen, J., Møller, J. E., Holmvang, L., & Hassager, C. (2021) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000000835 · Cited by 6 · see citing works
Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients
Alıcı, G., Quisi, A., Genç, Ö., Harbalıoğlu, H., Allahverdiyev, S., Yıldırım, A., Urgun, Ö. D., & Gür, M. (2021) · Düzce Tıp Fakültesi Dergisi · doi:10.18678/dtfd.868952 · Cited by 6 · see citing works
The year in cardiology 2016: Acute coronary syndromes
Crea, F., Binder, R. K., & Lüscher, T. F. (2017) · Srce i krvni sudovi · doi:10.5937/siks1701011c · Cited by 6 · see citing works
Clinical Value of Single-Projection Angiography–Derived FFR in Noninfarct-Related Artery
Kwon, W., Choi, K. H., Lee, S. H., Hong, D., Shin, D., Kim, H. K., Park, K. H., Choo, E. H., Kim, C. J., Kim, M. C., et al. (2024) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.123.013844 · Cited by 5 · see citing works
Meta-analysis of immediate complete vs staged complete revascularization in patients with acute coronary syndrome and multivessel disease
Singh, S. T., Garg, A., Chaudhary, R., Rout, A., Tantry, U. S., Bliden, K. P., & Gurbel, P. A. (2023) · Cardiovascular revascularization medicine · doi:10.1016/j.carrev.2023.10.005 · Cited by 5 · see citing works
Complete Revascularisation Following Acute MI: A Contemporary Review
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Authors: Sardella, G., Lucisano, L., Garbo, R., Pennacchi, M., Cavallo, E., Stio, R. E., Calcagno, S., Ugo, F., Boccuzzi, G., Fedele, F., & Mancone, M.
Affiliations: Sapienza University of Rome (IT)
Ospedale San Giovanni Bosco (IT)
Corresponding author: Sardella, Gennaro
ORCID: Sardella, Gennaro
Lucisano, Luigi
Garbo, Roberto
Pennacchi, Mauro
Calcagno, Simone
Ugo, Fabrizio
Boccuzzi, Giacomo
Fedele, Francesco
Mancone, Massimo
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2016-01
Volume: 67
Issue: 3
Pages: 264-272
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2015.10.082
OpenAlex: W2266436320
Cited by: 168
References: 28
Citations by year: 2026: 9 · 2025: 17 · 2024: 25 · 2023: 25 · 2022: 17 · 2021: 18 · 2020: 15 · 2019: 14 · 2018: 11 · 2017: 9 · 2016: 7 · 2013: 1
FWCI: 15.13
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 391 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Topics: Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Keywords: complete coronary revascularization, major adverse cardiac and cerebrovascular events, target vessel revascularization, cardiovascular mortality, long-term outcomes, multivessel coronary artery disease, reinfarction, stroke, hospital readmission
MeSH terms: Coronary Vessels, Humans, Myocardial Infarction, Percutaneous Coronary Intervention

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Single-Staged Compared With Multi-Staged PCI in Multivessel NSTEMI Patients

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