FULL REVASC for patients
It is recommended that patients with an acute myocardial infarction (heart attack) get any blocked blood vessels in the heart (coronary arteries) opened with angioplasty (also called PCI). Angioplasty is performed in the hospital as soon as possible in order to restore blood flow to the heart and prevent damage to the heart muscle.
In quite many patients, one or more narrowed blood vessels are also noticed, in addition to the completely blocked vessel. It is unclear if it is good or necessary to also do angioplasty to the narrowed vessel (-s), or if it can be left with medical treatment only. To widen a narrow vessel is associated with increased acute risk but it may lower the long term risk for new heart attacks and the need for repeated operations.
Previous studies have shown that it might be safe to leave the additional narrowed artery without angioplasty, and that this usually does not give the patients symptoms. However, some smaller studies have shown that it may prevent future complications.
The FULL REVASC study therefore studies patients with acute myocardial infarction, where a blocked artery and also another narrowed artery is found. All patients will receive treatment according to international recommendations. Patients in the study will receive treatment in one of these ways:
- - “Full revascularisation and medical therapy” which means that all narrowed arteries will be treated with angioplasty during the hospital admission after close evaluation of the degree and narrowing.
- - “Medical therapy only”. The remaining narrowed artery (-ies) will be left alone and treated with angioplasty only if and when causing symptoms.
Follow-up for patients will be through telephone interview after 30 days and 1 year. In addition data will be collected from public healthcare registries.
The goal is to evaluate 4000 patients in the study during three years. Many hospitals in the Nordic countries will collaborate on this study. We anticipate that the results of this study will influence how patients with myocardial infarctions will be treated all over the world.
The study is funded by the Swedish Research Council (Vetenskapsrådet), the Swedish Heart and Lung Foundation and by other public sources. Companies will support with some of the technical equipment needed.
The principal investigator of the study is Dr Felix Böhm at Karolinska University Hospital in Stockholm, Sweden.
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