Evidence map›Paper›PMID 41117658›Full record

Trial reportEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2025

Impact of complete revascularisation in relation to left ventricular function in patients with ST-segment elevation myocardial infarction and multivessel disease: a post hoc analysis of the COMPLETE randomised trial.

Denise Tiong, Natalia Pinilla-Echeverri, David A Wood, Roxana Mehran, Robert F Storey, Laurent Feldman, Raul Moreno, Sunil Rao, Warren J Cantor, Robert Welsh and 10 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Denise TiongMcMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Natalia Pinilla-EcheverriMcMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
David A WoodUniversity of British Columbia, Vancouver, BC, Canada.
Roxana MehranThe Zena A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Robert F StoreyDivision of Clinical Medicine, University of Sheffield, Sheffield, United Kingdom.
Laurent FeldmanUniversité Paris-Cité, INSERM U-1148, AP-HP, Hôpital Bichat, Paris, France.
Raul MorenoUniversity Hospital La Paz, IdiPAZ, Madrid, Spain and Universidad Autónoma de Madrid, Madrid, Spain.
Sunil RaoNYU Langone Health System, New York, NY, USA.
Warren J CantorSouthlake Regional Health Centre, Toronto, ON, Canada and University of Toronto, Toronto, ON, Canada.
Robert WelshMazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada.
Kevin R BaineyMazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada.
Eric A CohenSunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Michael B TsangMcMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Matthew SibbaldMcMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Madhu K NatarajanMcMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Dilani WijesenaPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Thenmozhi ManiPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Helen NguyenPopulation Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
John A CairnsUniversity of British Columbia, Vancouver, BC, Canada.
Shamir R MehtaMcMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COMPLETE trial demonstrated a reduction in cardiovascular (CV) death or new myocardial infarction (MI) after complete, rather than culprit-only, revascularisation in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD). However, it is unknown whether this benefit varies according to baseline left ventricular ejection fraction (LVEF).

aimsWe aimed to determine the effects of complete versus culprit-only revascularisation according to LVEF.

methodsBaseline LVEF was available for 2,214 of 4,041 randomised patients. The effect of both strategies on the first co-primary outcome of CV death or new MI and the second co-primary outcome of CV death, new MI, or ischaemia-driven revascularisation (IDR) was determined within the prespecified LVEF ranges of <45% (N=660) and ≥45% (N=1,554). An analysis of clinical outcomes by LVEF according to thirds was also conducted.

resultsPatients with LVEF <45% experienced a significantly higher incidence of the first co-primary outcome compared with those with LVEF ≥45% (4.2%/year vs 2.8%/year; hazard ratio [HR] 1.51, 95% confidence interval [CI]: 1.15-1.98; p=0.003). Compared with a culprit-only strategy, complete revascularisation consistently reduced the first co-primary outcome in patients with LVEF <45% (3.0%/year vs 5.5%/year; HR 0.55, 95% CI: 0.36-0.86) and those with LVEF ≥45% (2.4%/year vs 3.2%/year; HR 0.74, 95% CI: 0.52-1.04; interaction p=0.31). Complete revascularisation also consistently reduced the second co-primary outcome in patients with LVEF <45% (3.5%/year vs 7.3%/year; HR 0.49, 95% CI: 0.33-0.74) and those with LVEF ≥45% (2.7%/year vs 6.3%/year; HR 0.44, 95% CI: 0.33-0.60; interaction p=0.67). Consistent results were observed for both co-primary outcomes when LVEF was further stratified into categories of LVEF ≤35%, 36-49% and ≥50%.

conclusionsAmong patients presenting with STEMI and MVD, those with reduced LVEF are at higher risk of ischaemic events than patients with preserved LVEF. There is a consistent benefit of complete revascularisation regardless of baseline LVEF.

Indexed as

Coronary Artery DiseaseMyocardial InfarctionMyocardial RevascularizationPercutaneous Coronary InterventionST Elevation Myocardial InfarctionVentricular Function, LeftAgedFemaleHumansMaleMiddle AgedStroke VolumeTreatment Outcome

Identifiers

PMID41117658
PMCPMC12517193

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.