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Hemodynamics Management

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Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial:


  • The article reports the results of a randomised trial that compared two strategies of complete revascularisation for patients with acute coronary syndrome and multivessel coronary disease: immediate or staged.

  • The trial enrolled 1525 patients from 29 hospitals across four European countries and randomly assigned them to either receive complete revascularisation (including non-culprit lesions) during the index procedure (immediate group) or within 30 days after the index procedure (staged group).

  • The primary outcome was a composite of all-cause mortality, myocardial infarction, and unplanned ischaemia-driven revascularisation at 1 year after the index procedure.

  • The trial found that immediate complete revascularisation was non-inferior to staged complete revascularisation for the primary outcome, with a hazard ratio of 0·78 (95% CI 0·55–1·11, p non-inferiority =0·0011).

  • The trial also found that immediate complete revascularisation was associated with a reduction in myocardial infarction and unplanned ischaemia-driven revascularisation compared to staged complete revascularisation.


Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial - The Lancet

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