Complete revascularization has shown in several studies and meta-analysis a benefit in mortality vs. incomplete revascularization.
The REVIVED-BCIS looked at whether there were differences in mortality and hospitalization for cardiac failure in patients with ventricular function deterioration and viability when comparing coronary angioplasty(PCI) against optimal medical treatment. This study showed that PCI was not associated with significant changes in the established final outcomes.
Of 266 patients undergoing PCI, 130 received complete revascularization and 136 incomplete revascularization. Complete revascularization was defined as anatomical according to coronary revascularization index (Δ Score BCIS), or viability guided, according to myocardial revascularization index.
In terms of anatomical revascularization, there were no significant differences between incomplete anatomical revascularization and optimal medical treatment (HR 0.97; P=0.85). Also, complete anatomical revascularization did not show significant differences (HR 0.90; P=0.59).
When looking at viability guided revascularization, neither were there differences in favor of revascularization vs optimal medical treatment, both with complete (HR 0.95; p=0.76) and incomplete revascularization (HR 0.83; p=0.28).
Authors’ conclusion: The REVIVED-BCIS2, on patients with stable coronary artery disease and severe ventricular dysfunction, neither complete anatomical revascularization or viability guided revascularization generated changes in clinical events.
Dr. Omar Tupayachi.
Member of the Editorial Board of SOLACI.org.
Reference: Presented by Margaret Mcentegart, at Late-Breaking Clinical Trials, EuroPCR 2024, May 14-17, Paris, France.
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