Jackson MWP, et al. – Given that the PRAMI and CvLPRIT studies support preventive percutaneous coronary intervention (PCI) for multivessel coronary disease found during ST-segment elevation myocardial infarction (STEMI), researchers investigated the real-world experience of the management of multivessel disease identified during primary PCI (PPCI) in a large UK regional center. Participants included all patients with STEMI who underwent culprit-only PPCI during the August 2011-August 2013 study period; they were retrospectively assessed for trial eligibility. The two resulting groups represented the “observational” cohorts. Thereafter, primary outcomes were determined and compared with the culprit-only revascularization cohorts from the respective published randomized controlled trials (RCTs). Of 1,143 cases presented during the study period, 343 participants were included in the observational PRAMI cohort and 196 were included in the observational CvLPRIT cohort. Findings showed that outcomes from the culprit-only PCI for multivessel disease in patients selected by the RCT criteria from an all-comers population representing real-life experience were found to be better than those published in the two main RCTs. The RCTs may have selected a high-risk population for study exaggerating the benefits of preventive PCI.