Complete revascularization shows high probability of benefit for NSTEMI patients with multivessel disease

This study looked at patients presenting with non-ST-elevation myocardial infarction and multivessel disease. The researchers performed a Bayesian re-analysis of a previous trial to evaluate treatment options. They compared complete revascularization against culprit-only revascularization. The analysis included 478 patients in the population. Results showed a high probability of benefit for the composite endpoint of death, heart attack, repeat procedures, and stroke. The probability of any benefit was 99.8%. There was also a high probability of clinically relevant benefit for repeat revascularization. A benefit for nonfatal heart attack was also likely. Safety concerns were not reported in this analysis. The main reason to be careful is that this is a post hoc re-analysis. Results were consistent across all priors used. Readers should take away that complete revascularization provides a high probability of clinically meaningful benefit in these specific patients. This finding comes from a re-analysis rather than a new trial. The evidence supports a link between the procedure and improved outcomes in this group.