{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:18:24Z","timestamp":1789496304733,"version":"build-2803163510"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Complete revascularization is superior to culprit lesion\u2013only percutaneous coronary intervention (PCI) in reducing ischemic events in patients with ST-segment\u2013elevation myocardial infarction and multivessel disease. However, the relationship between the extent of revascularization and the benefits of a complete revascularization strategy remains unclear. The aim of this substudy of the COMPLETE trial (Complete versus Culprit-Only Revascularization Strategies to Treat Multivessel Disease after Early PCI for STEMI) was to evaluate how the degree of anatomic completeness of revascularization, measured by the core laboratory-derived modified residual SYNTAX score (R\u2032SS), relates to major cardiovascular events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted an exploratory post hoc analysis of the COMPLETE trial (N=3738), stratifying patients randomized in the complete revascularization group based on the R\u2032SS assessed after staged nonculprit lesion\u2013PCI. Complete revascularization was defined by an R\u2032SS=0, whereas incomplete revascularization was defined by an R\u2032SS&gt;0. A stratified Cox proportional hazards model was used, with the culprit-only PCI arm designated as the reference group for comparison. The first coprimary outcome was a composite of cardiovascular death or new myocardial infarction. The second coprimary outcome was a composite of cardiovascular death, new myocardial infarction, or ischemia-driven revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Among patients randomized to a complete revascularization strategy, 90% achieved complete revascularization (R\u2032SS=0), whereas 10% did not (R\u2032SS&gt;0). In patients with R\u2032SS=0, the first coprimary outcome occurred less frequently (6.6%) compared with those randomized to the culprit lesion\u2013only PCI strategy (10.7%; adjusted hazard ratio, 0.61 [95% CI, 0.47\u20130.78]). Among patients with an R\u2032SS&gt;0, the first coprimary outcome was similar (10.7%) to those in the culprit lesion\u2013only PCI group (10.7%; adjusted hazard ratio, 1.01 [95% CI, 0.61\u20131.67]). A similar result was observed for the second coprimary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>This exploratory analysis of the COMPLETE trial suggests that the benefit of a complete revascularization strategy in patients with ST-segment\u2013elevation myocardial infarction and multivessel disease may be related to the extent of anatomic completeness of revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT01740479.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.126.016515","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T09:01:26Z","timestamp":1780477286000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Revascularization Completeness on Cardiovascular Outcomes in STEMI With Multivessel Disease"],"prefix":"10.1161","volume":"19","clinical-trial-number":[{"clinical-trial-number":"nct01740479","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6366-6211","authenticated-orcid":true,"given":"Mehdi","family":"Madanchi","sequence":"first","affiliation":[{"name":"Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (M.M., N.P.-E., T.S., H.N., T.M., S.R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7784-0348","authenticated-orcid":true,"given":"Natalia","family":"Pinilla-Echeverri","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (M.M., N.P.-E., T.S., H.N., T.M., S.R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5117-2353","authenticated-orcid":true,"given":"David A.","family":"Wood","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Innovation, University of British Columbia, Canada (D.A.W., J.A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4651-8310","authenticated-orcid":true,"given":"Tej","family":"Sheth","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (M.M., N.P.-E., T.S., H.N., T.M., S.R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-6229","authenticated-orcid":true,"given":"Robert F.","family":"Storey","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, University of Sheffield, United Kingdom (R.F.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2975-6971","authenticated-orcid":true,"given":"Vijay","family":"Kunadian","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne, United Kingdom (V.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5150-188X","authenticated-orcid":true,"given":"Gianluca","family":"Campo","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy (G.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7179-1426","authenticated-orcid":true,"given":"Raul","family":"Moreno","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital La Paz, Madrid, Spain (R. Moreno)."},{"name":"Universidad Aut\u00f3noma de Madrid, Spain (R. Moreno)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5546-262X","authenticated-orcid":true,"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[{"name":"The Zena A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York (R. Mehran)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2914-0894","authenticated-orcid":true,"given":"Sunil V.","family":"Rao","sequence":"additional","affiliation":[{"name":"New York University Grossman School of Medicine (S.V.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5458-4617","authenticated-orcid":true,"given":"Kevin R.","family":"Bainey","sequence":"additional","affiliation":[{"name":"Mazankowski Alberta Heart Institute, University of Alberta, Canada (K.R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8547-3004","authenticated-orcid":true,"given":"Tomas","family":"Cieza","sequence":"additional","affiliation":[{"name":"Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec, Laval University, Canada (T.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3217-0835","authenticated-orcid":true,"given":"Helen","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (M.M., N.P.-E., T.S., H.N., T.M., S.R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3932-5625","authenticated-orcid":true,"given":"Thenmozhi","family":"Mani","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (M.M., N.P.-E., T.S., H.N., T.M., S.R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-8841","authenticated-orcid":true,"given":"John A.","family":"Cairns","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Innovation, University of British Columbia, Canada (D.A.W., J.A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3258-949X","authenticated-orcid":true,"given":"Shamir R.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Population Health Research Institute, McMaster University and Hamilton Health Sciences, Ontario, Canada (M.M., N.P.-E., T.S., H.N., T.M., S.R.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1907775"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12113-7"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001397"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1251"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200009283431303"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001803"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.06.006"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.124.014667"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2104650"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac763"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.06.069"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008768"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.09.079"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht484"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.09.034"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00413-6"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1002358"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00055-8"}],"container-title":["Circulation: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCINTERVENTIONS.126.016515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:00:20Z","timestamp":1789495220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCINTERVENTIONS.126.016515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1161\/CIRCINTERVENTIONS.126.016515"],"URL":"https:\/\/doi.org\/10.1161\/circinterventions.126.016515","relation":{},"ISSN":["1941-7640","1941-7632"],"issn-type":[{"value":"1941-7640","type":"print"},{"value":"1941-7632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}