1. SMILE
Trial design: NSTEMI patients were randomized to complete revascularization during the index procedure (i.e., 1-stage revascularization; n = 264) vs. culprit-only revascularization during the index procedure plus deferred complete revascularization within 3-7 days (i.e., 2-stage revascularization; n = 263).
Results
(p = 0.004)
Death, MI, rehospitalization for unstable angina, TVR, or stroke at 1 year: 13.6% of the 1-stage group vs. 23.2% of the 2-stage group (p = 0.004)
The composite outcome was similar between treatment groups at 1 month (p = 0.78); however, at 6 months, there was benefit favoring 1-stage revascularization (p = 0.04)
23.2 %
13.6
Conclusions
Among NSTEMI patients, complete revascularization during the index procedure was superior to delayed complete revascularization within 3-7 days
Unclear why benefit was observed late in follow-up
1-stage revascularization
2-stage revascularization
Sardella G, et al. J Am Coll Cardiol 2016;67:264-72