Table 1.

Main characteristics of included randomized trials.

Trial/first author year	Setting	PCI strategies subgroups, n			Timing of staged MV-PCI	Definition of MVD	Inclusion criteria	Exclusion criteria	Primary endpoints	Follow-up time
		CO-PCI	Immediate MV-PCI	Staged MV-PCI
HELP AMI 20 2004	Multicenter	17	52	NA	NA	NA	The presence of ischemic chest pain started less than 12 h before hospital admission and ST-segment elevation of at least 1 mm in ⩾2 electrocardiographic leads (peripheral leads) or 2 mm in the precordial leads	The presence of significant lesions in vein grafts or arterial conduits or in segments previously treated with angioplasty or stent implantation, recent thrombolysis (<1 week), cardiogenic shock	Revascularization	12 months
Politi et al. 21	Single centre	84	65	65	56.8 ± 12.9 days	>70% diameter stenosis of ⩾2 epicardial coronary arteries or their major branches by visual estimation	The presence of prolonged (>30 min) chest pain, started <12 h before hospital arrival and ST-elevation of at least 1 mm in ⩾2 contiguous limb electrocardiographic leads or 2 mm in precordial leads	Cardiogenic shock, LM disease, previous CABG, severe valvular heart disease and unsuccessful procedures	MACE defined as cardiac or non-cardiac death, in-hospital death, re-infarction, rehospitalization for acute coronary syndrome and repeat coronary revascularization	2.5 ± 1.4 years
Maamoun et al. 26	Single centre	NA	42	36	Within 7 days	⩾2 angiographically documented diseased coronary arteries (luminal diameter narrowing ⩾70%)	STEMI presented within 12 h from the onset of symptom with MVD and received primary PCI	Cardiogenic shock, pulmonary edema and LM disease	MACE including death (cardiac or non-cardiac), re-infarction, rehospitalization for recurrent angina, TVR and cerebrovascular accidents	12 months
Ghani et al. 23	Single centre	41	NA	80	In-hospital or in an outpatient setting within 3 weeks after STEMI	⩾2.5 mm diameter stenosis of ⩾50% in ⩾2 major epicardial coronary arteries	Patients with multivessel disease who underwent successful primary angioplasty for STEMI	Urgent indication for additional revascularization, >80 years old, CTO of one of the non-IRA, previous CABG, LM stenosis of ⩾50%, restenotic lesions in non-IRA, chronic atrial fibrillation, limited life expectancy, other factors that made complete follow-up unlikely	Ejection fraction at 6 months	3 years
PRAMI 5 2013	Multicentre	231	234	NA	NA	Stenosis of ⩾50% in ⩾1 coronary artery other than the IRA	IRA had been treated successfully and there was stenosis of 50% or more in ⩾1 coronary artery other than the IRA and the stenosis was deemed to be treatable by PCI	Cardiogenic shock, unable to provide consent, previous CABG, non-IRA stenosis of ⩾50% in the LM or the ostia of both the left anterior descending and circumflex arteries, or the only noninfarct stenosis was a CTO	Composite of death from cardiac causes, nonfatal myocardial infarction or refractory angina	23 months
Roman et al. 27	Single centre	NA	46	43	8.5 ± 4.2 days	⩾70% diameter stenosis of ⩾2 epicardial coronary arteries or their major branches by visual estimation with diameter ⩾2.5 mm	⩾18 years, provided written informed consent prior to any study-related procedure, significant stenoses (⩾70%) of ⩾2 of coronary arteries and requiring primary PCI for STEMI within 12 h, target lesions located in a native coronary artery with visually estimated diameter of 2.5–4.0 mm, amenable for PCI	Single lesions, acute heart failure Killip III-IV, ⩾50% LM stenosis, small vessels diameter (<2.5 mm), hypersensitivity or contraindication to any of the following medications: Heparin Aspirin Both Clopidogrel and Ticlopidine, Zotarolimus	All death (cardiac and non-cardiac), any MI (STEMI and non-STEMI), TVR	6 months
DANAMI-3-PRIMULTI 7 2015	Multicentre	313	NA	314	2 days after the initial PCI procedure before discharge	Angiographic diameter stenosis of ⩾ 50% in ⩾1 non-IRA of 2 mm or larger in diameter	Chest pain of <12 h duration and ST-segment elevation >0.1 mV in ⩾2 contiguous leads, successful treatment of IRA	Intolerance of contrast media or of relevant anticoagulant or antithrombotic drugs, unconsciousness or cardiogenic shock, stent thrombosis, indication for CABG, or increased bleeding risk	Composite of all-cause mortality, re-infarction, or ischaemia-driven (subjective or objective) revascularization of lesions in non-IRA	27 months
CvLPRIT 6 2015	Multicentre	146	97	42	Before hospital discharge	>70% diameter stenosis in one plane or >50% in two planes, the non-IRA should be a major (>2 mm) epicardial coronary artery or branch (>2 mm)	Patients presented within 12 h of symptom onset with MVD and non-IRA stenosis >70%	Any exclusion criteria for P-PCI, <18 years, contraindication to multi vessel P-PCI according to operator judgement, previous Q wave MI, prior CABG, cardiogenic shock, VSD or moderate/severe mitral regurgitation, chronic kidney disease, suspected or confirmed thrombosis of a previously stented artery, the only significant no-IRA lesion is a CTO	MACE comprising all-cause mortality, recurrent MI, heart failure, and ischemic-driven revascularization by PCI/CABG	5.6 years
Zhang et al. 24	Single centre	213	NA	215	Within 7–10 days after AMI	Angiographic diameter stenosis of 75–90% in ⩾1 non-IRA of 2.5 mm or larger in diameter	STEMI with MVD, stenosis of 75–90% in ⩾1 non-IRA of 2.5 mm or larger in diameter	Cardiogenic shock, prior CABG, unconfirmed IRA, patients refused further PCI, the significant no-IRA lesion is a CTO, stenosis >90%	MACE defined as recurrent MI and cardiac death	24 months
PRAGUE 13 25 2015	Multicentre	108	NA	106	3–40 days after PPCI	⩾1 significant (⩾70%) stenosis of non-IRA	STEMI, successful primary PCI of IRA (TIMI flow grades II-III), ⩾1 stenosis (⩾70%) of non-IRA (diameter of artery ⩾2.5 mm) found by coronary angiography, enrolment ⩾48 h following onset of symptoms	Stenosis of the LM ⩾50%, hemodynamically significant valvular disease, cardiogenic shock during STEMI, hemodynamic instability, angina pectoris >grade 2 CCS lasting 1 month prior to STEMI	MACE defined as all-cause mortality, nonfatal MI, stroke	38 months
Hamza et al. 22	Multicentre	50	29	21	Within 72 h during hospitalization	Angiographic stenosis ⩾80% in non-IRA	STEMI with MVD in patients with diabetes within 12 h of symptoms	Lesions from 50% to 70% stenosis, CTO of one of the non-IRA, previous CABG or LM stenosis >50%	The composite of all-cause mortality, recurrent MI, and ischaemia-driven revascularization at 6 months	6 months
Compare-Acute 8 2017	Multicentre	590	295	NA	Generally during the same intervention, delayed had to be during index hospitalization and preferably within 72 h	NonIRA (or their major side branches of ⩾2.0 mm in diameter) showed stenosis ⩾50%	STEMI with MVD that was appropriate for FFR and PCI	LM disease, CTO, severe stenosis, TIMI flow grade ⩽2 in the non-IRA, a suboptimal result or complications after treatment of an IRA, severe valve dysfunction, and Killip class III or IV	The composite of all-cause mortality, nonfatal myocardial infarction, any revascularization and MACCE	12 months
COMPLETE 9 2019	Multicentre	2025	NA	2016	Index hospitalization or after hospital discharge within 45 days after randomization	⩾1 angiographically significant non-IRA lesion (⩾70% stenosis of the vessel diameter on visual estimation or with 50–69% stenosis .accompanied by FFR ⩽0.80) and vessel diameter ⩾2.5 mm	Presented to the hospital with STEMI and could undergo randomization within 72 h after successful culprit-lesion PCI	An intention before randomization to revascularize a non-IRA lesion, a planned surgical revascularization, or previous CABG	The composite of death from cardiovascular causes or new myocardial infarction	3 years

AMI, acute myocardial infarction; CABG, coronary artery bypass graft; CCS, Canadian Cardiovascular Society; Compare-Acute, Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With Multivessel Coronary Artery Disease; COMPLETE, Complete vs Culprit-only Revascularization to Treat Multi-vessel Disease After Early PCI for STEMI; CO-PCI, culprit-only percutaneous coronary intervention; CTO, chronic total occlusion; CvLPRIT, Complete Versus Lesion-Only Primary PCI Trial; DANAMI-3-PRIMULTI, Third Danish Study of Optimal Acute Treatment of Patients with ST-segment Elevation Myocardial Infarction: Primary PCI in Multivessel Disease; FFR, fractional flow reserve; HELP AMI, HEpacoat for cuLPrit or multivessel stenting for Acute Myocardial Infarction; IRA, infarct-related coronary artery; LM, left main coronary artery; MACCE, major adverse cardiac and cerebrovascular events; MACE, major adverse cardiac events; MI, myocardial infarction; MVD, multivessel disease; MV-PCI, multivessel percutaneous coronary intervention; PCI, percutaneous coronary intervention; PRAMI, Preventive Angioplasty in Myocardial Infarction; STEMI, ST-elevation myocardial infarction; TIMI, thrombolysis in myocardial infarction; TVR, target vessel revascularization; VSD, ventricular septal defect.