ESC Congress 2024 — Complete revascularisation is safe, reduces ischemic events for up to 4 years, and does not affect long-term mortality.

We are joined onsite by Dr Gianluca Campo (University of Ferrara, Ferrara, IT) to discuss the findings from EARTH-STEMI. Previous RCTs have supported the benefit of complete revascularisation in the overall population, however, this has not been confirmed in populations of older STEMI patients. The EARTH-STEMI meta-analysis combines data from RCTs, including FIRE, COMPARE-ACUTE, DANAMI-PRIMULTI, CVLPRIT and COMPLETE with an aim to determine the best revascularisation strategy for older STEMI patients.

Findings showed that in STEMI patients aged ≥75 years with multivessel diease, complete revascularization is safe and reduced ischemic events for up to 4 years post-procedure. Cardiovascular death and MI were reduced over time, and long-term mortality was not affected. There were no concerns regarding safety endpoints in patients undergoing complete revascularization. 

Interview Questions: 

1. What is the reasoning for this meta-analysis?
2. Could you tell us about the trials included in the analysis?
3. What are the key findings?
4. Was there anything surprising revealed in the data?
5. What should be the impact of these results on clinical practice?
6. What are the next steps?

Recorded on-site at ESC Congress 2024, London.

Editors: Jordan Rance and Mirjam Boros.
Videographers: Mike Knight, Dan Brent, Oliver Miles, Tom Green, David-Ben-Harosh.

Support: This is an independent interview produced by Radcliffe Cardiology.