Will this trial change my practice? PRAMI - treatment of bystander coronary lesions in patients undergoing primary PCI for acute STEMI

The PRAMI trial, published in the New England Journal of Medicine, investigated in a multicentric randomised fashion whether “on the spot full revascularisation” provides outcome benefits in patients with multivessel disease presenting with a ST-elevation myocardial infarction (STEMI), as compared to a “culprit alone strategy”1. The study enrolled 465 patients with acute STEMI, who underwent primary PCI of the culprit lesion and were randomly assigned 1:1 either to “preventive PCI” of all non-culprit lesions with more than 50% diameter stenosis during the same procedure (234 patients) or to “no preventive PCI” (231 patients).

The study was terminated early on the advice of the data ...