Is Complete Revascularization Now Compulsory? MULTISTARS-AMI and FIRE in Context

This transcript has been edited for clarity.

Michelle L. O'Donoghue, MD, MPH: Hi. This is Dr Michelle O'Donoghue reporting for Medscape. Joining me today is Dr Sahil Parikh, who's a cardiologist and an interventionalist at Columbia University. He's an associate professor of medicine.

We'll be discussing two interesting trials that were presented at the ESC Congress here in Amsterdam. They do have the potential to be very practice-changing, so I think it's worth talking about.

The FIRE Trial

The first trial we'll be talking about is the FIRE trial. Perhaps setting the stage, Sahil, I'd love to get your thoughts. We've had data in this space to suggest that, for patients with STEMI [ST-segment elevation myocardial infarction], a strategy of complete revascularization — and not only treating the culprit lesion but also treating additional lesions — may be of benefit. Where does that lead us in terms of what we didn't know?

Sahil A. Parikh, MD: I think that the practice has moved, at least in the United States, over the past two decades, from staging percutaneous coronary interventions (PCIs) over 30 days from index to intervention to now trying to do patients in the same hospitalization whenever possible to achieve complete revascularization.