Multivessel versus culprit-only PCI in STEMI patients with multivessel disease: meta-analysis of randomized controlled trials View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-04-01

AUTHORS

Hans-Josef Feistritzer, Alexander Jobs, Suzanne de Waha-Thiele, Ingo Eitel, Anne Freund, Mohamed Abdel-Wahab, Steffen Desch, Holger Thiele

ABSTRACT

AimsTo perform a pairwise meta-analysis of randomized controlled trials (RCTs) comparing multivessel percutaneous coronary intervention (PCI) and culprit vessel-only PCI in ST-elevation myocardial infarction (STEMI) patients without cardiogenic shock.MethodsWe searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase for RCTs comparing multivessel PCI with culprit vessel-only PCI in STEMI patients without cardiogenic shock and multivessel coronary artery disease. Only RCTs reporting mortality or myocardial reinfarction after at least 6 months following randomization were included. Hazard ratios (HRs) were pooled using random-effect models.ResultsNine RCTs were included in the final analysis. In total, 523 (8.3%) of 6314 patients suffered the combined primary endpoint of death or non-fatal reinfarction. This primary endpoint was significantly reduced with multivessel PCI compared to culprit vessel-only PCI (HR 0.63, 95% confidence interval [CI] 0.43–0.93; p = 0.03). This finding was driven by a reduction of non-fatal reinfarction (HR 0.64, 95% CI 0.52–0.79; p = 0.001), whereas no significant reduction of all-cause death (HR 0.77, 95% CI 0.44–1.35; p = 0.28) or cardiovascular death (HR 0.64, 95% CI 0.37–1.11; p = 0.09) was observed.ConclusionsIn STEMI patients without cardiogenic shock multivessel PCI reduced the risk of death or non-fatal reinfarction compared to culprit vessel-only PCI. More... »

PAGES

1381-1391

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00392-020-01637-6

DOI

http://dx.doi.org/10.1007/s00392-020-01637-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1126057430

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32239284


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