Complete Revascularization with Multivessel PCI for Myocardial Infarction

To the Editor: Mehta et al. (Oct. 10 issue)(1) report that complete revascularization was superior to culprit-lesion-only percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease in the Complete versus Culprit-Only Revascularization Strategies to Treat Multivessel Disease after Early PCI for STEMI (COMPLETE) trial. Mehta and colleagues note that the culprit-lesion-only PCI group received "medical therapy with no further revascularization, regardless of whether there was evidence of ischemia on noninvasive testing." The crossover rate to complete revascularization among these patients was only 4.7% within 45 days. However, guidelines support risk stratification based . . .