Abstract
There is only one big risk you should avoid at all costs, and that is the risk of doing nothing.
Highlights
Clear answers can only be provided by large dedicated randomised controlled trials with adequate power and predefined guiding on post-procedural care, patient information and treatment timing of repeat interventions
Treatment groups differ in age, diabetes, presence of haemodynamic instability and disease complexity
Not even to speak about the huge imbalance in numbers of patients per group; multivessel PCI was performed in only 13.9 % of the patients versus 86.1 % who received infarct artery only treatment as demonstrated by Rasoul and colleagues
Summary
Comparing ‘ad hoc’ multivessel versus infarct-related artery-only revascularisation in the setting of STEMI and multivessel disease is an oversimplification of the actual clinical problem. Clear answers can only be provided by large dedicated randomised controlled trials with adequate power and predefined guiding on post-procedural care, patient information and treatment timing of repeat interventions. The lack of these clear guidelines, typically applied in randomised controlled trials, is exactly the reason why observational and mostly retrospective studies fail to provide convincing answers to our clinical dilemma.
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