The findings of the COMPLETE revascularization with multivessel PCI for myocardial infarction were published September 1, 2019 in the New England Journal of Medicine (NEJM), showing that opening all clogged arteries with stents after a serious heart attack is much better than opening only the single clogged artery that caused the heart attack. Dr. Shamir Mehta, PI on COMPLETE, presented the findings as a late-breaking science session at the European Society of Cardiology (ESC) Congress in Paris, France on September 1st, 2019.
COMPLETE is the the first large, randomized, international trial to show a reduction in major outcomes with this approach. The publication of COMPLETE findings has been recognized as one of the NEJM Top Articles of 2019; and as one of the Top Cardiology Trials of 2019.
About half of all heart attack victims are found to have additional clogged arteries in addition to the one that caused their heart attack. Previously, doctors focused on opening the one artery responsible for the heart attack, leaving the other blockages for treatment with medication alone. The new study, a collaboration of 130 hospitals in 31 countries, has shown that opening all the blockages is better than treating only the one blockage causing the heart attack. This led to a 26% reduction in the patient’s risk of dying or having a recurrent heart attack.
“Given its large size [4,041 patients], international scope and focus on patient-centered outcomes, the COMPLETE trial will change how doctors treat this condition and prevent many thousands of recurrent heart attacks globally every year,” said Mehta, who is the Senior Scientific Program Lead, ACS and Interventional Cardiology at PHRI. “The benefits emerged over the long term and were similar when the additional stent procedures were done anytime in the first 45 days after the heart attack.”
Read the slides on COMPLETE from ESC 2109.
COMPLETE Timing sub-study
The substudy, COMPLETE TIMING, was presented at TCT2019 conference in San Francisco on September 28, 2019, by the NEJM paper’s coauthor, David Wood. (Watch video interview by American College of Cardiology of Dr. Wood below.)
Read the COMPLETE Timing slides from TCT 2019.
The paper, Timing of Staged Nonculprit Artery Revascularization in Patients With ST-Segment Elevation Myocardial Infarction: COMPLETE Trial was published in JACC.
COMPLETE OCT sub-study
The COMPLETE optical coherence tomography (OCT) sub-study garnered international attention at the American Heart Association (AHA) 2019 Scientific Sessions in Philadelphia in November. The results of COMPLETE OCT were presented by Dr. Natalia Pinilla-Echeverri of McMaster University (shown here being interviewed at AHA).