Physiology-guided complete revascularization reduces the 3-year risk of death, MI, stroke, or ischemia-driven revascularization in older patients (≥75 years) compared to culprit-only strategies.
The clinical benefit of complete revascularization is consistent across the spectrum of renal function, including patients with an eGFR <60 mL/min/1.73 m2.
Despite higher baseline risks, patients with chronic kidney disease (CKD) did not experience a higher rate of contrast-associated acute kidney injury (CA-AKI) with the complete revascularization strategy compared to the culprit-only approach.
These findings suggest that advanced age and renal impairment should not be automatic barriers to comprehensive multivessel intervention in the setting of myocardial infarction.
Introduction: The Intersection of Aging, Renal Impairment, and Ischemic Heart Disease
