ACC 2023 | Complete Revascularization Strategies in patients with ACS and Multivessel Disease

In patients with acute coronary syndrome (ACS) and multivessel disease, complete revascularization is associated with better clinical outcomes. However, for non-culprit vessel revascularization the strategy remains unclear. 

ACC 2023 | Estrategias de revascularización completa en pacientes con síndrome coronario agudo y enfermedad coronaria de múltiples vasos

The aim of this multicenter, open label, randomized, non-inferiority study, was to determine whether complete revascularization during index procedure is non inferior vs. staged. 

Primary end point was a composite of all-cause mortality, AMI, any unplanned ischemia-driven revascularization, and cerebrovascular events at 1 year. 

It included 1525 patients randomized to complete revascularization during index procedure (N= 764) vs. staged within 6 weeks after index procedure (N=761). Mean age was 65. Patients were mostly men. The most frequent form of presentation was non ST elevation ACS. 

Read also: ACC 2023 | TAVR in Low Risk Patients: 3-Year Outcomes.

Primary end point resulted lower in the immediate revascularization group with HR: 0·78 (95% CI, 0·55-1·11) p=0·001 for non-inferiority and p=0·166 for superiority, at the expense of a lower rate of AMI (P=0.005) and unplanned ischemia driven revascularization (P=0.030). 


In patients with ACS and multivessel disease, immediate complete revascularization resulted non-inferior to staged revascularization, as regards the primary end point, and was also associated to lower AMI and unplanned ischemia driven revascularization at 1 year. 

Dr. Andrés Rodríguez

Dr. Andrés Rodríguez.
Member of the Editorial Board of

Original Title: Complete Revascularization Strategies in Patients Presenting With Acute Coronary Syndrome and Multivessel Coronary Disease.

Reference: Roberto Diletti MD, PhD et al.

Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology