PMID- 20517993
OWN - NLM
STAT- MEDLINE
DCOM- 20110523
LR  - 20120325
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 77
IP  - 2
DP  - 2011 Feb 1
TI  - Complete versus culprit only revascularization in acute ST elevation myocardial 
      infarction: a meta-analysis.
PG  - 163-70
LID - 10.1002/ccd.22647 [doi]
AB  - BACKGROUND: Current guidelines recommend against the revascularization of 
      noninfarct related artery (complete revascularization [CR]) in patients with ST 
      elevation myocardial infarction (STEMI) and no hemodynamic compromise, though 
      level of evidence is C. AIM: Our aim was to examine the available evidence to 
      determine any advantage of CR over culprit only revascularization (COR). METHODS: 
      We systematically searched medline using key words-"culprit coronary 
      revascularization," "complete revascularization myocardial infarction," and 
      "multivessel STEMI" for studies reporting outcomes after COR versus CR during 
      primary procedure or index hospitalization published in English language and 
      indexed before February 2010. A random effect or fixed effect meta-analysis, as 
      applicable, was performed using RevMan 5 (Cochrane Center, Denmark). RESULTS: 
      Nine eligible nonrandomized studies amounting to 4,530 patients in CR and 27,323 
      patients in COR group were included. In addition, two small randomized trials 
      were reviewed and included in secondary analysis. Majority of patients were 
      hemodynamically stable. Major adverse cardiovascular events (Odds ratio [OR] = 
      0.95, 95% CI 0.47-1.90) and long term mortality (OR = 1.10, 95% CI 0.76-1.59) 
      were similar. The marginal increased odds of in-hospital mortality was derived 
      from a single study with no difference found after sensitivity and cumulative 
      analysis (OR = 1.21 95% CI 0.85-1.73). CONCLUSION: Current analysis of 
      heterogeneous studies did not reveal any benefit of CR over COR in patients with 
      STEMI. However, also provide no conclusive evidence of increased in hospital 
      mortality after CR. A randomized trial is needed to confirm these findings and 
      recognize any subgroup which might benefit from CR.
CI  - Copyright (c) 2010 Wiley-Liss, Inc.
FAU - Sethi, Ankur
AU  - Sethi A
AD  - Division of Cardiology, Rosalind Franklin University of Medicine and Sciences, 
      Chicago, IL, USA. drankursethi@gmail.com
FAU - Bahekar, Amol
AU  - Bahekar A
FAU - Bhuriya, Rohit
AU  - Bhuriya R
FAU - Singh, Sarabjeet
AU  - Singh S
FAU - Ahmed, Aziz
AU  - Ahmed A
FAU - Khosla, Sandeep
AU  - Khosla S
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
CIN - Catheter Cardiovasc Interv. 2011 Feb 1;77(2):171-3. PMID: 21290552
CIN - Catheter Cardiovasc Interv. 2012 Mar 1;79(4):681-2; author reply 683-4. PMID: 
      21954099
MH  - Cardiovascular Diseases/etiology/mortality
MH  - Chi-Square Distribution
MH  - Evidence-Based Medicine
MH  - Hemodynamics
MH  - Hospital Mortality
MH  - Humans
MH  - Myocardial Infarction/mortality/physiopathology/*therapy
MH  - Myocardial Revascularization/adverse effects/*methods/mortality
MH  - Odds Ratio
MH  - Patient Selection
MH  - Practice Guidelines as Topic
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2010/06/03 06:00
MHDA- 2011/05/24 06:00
CRDT- 2010/06/03 06:00
PHST- 2010/06/03 06:00 [entrez]
PHST- 2010/06/03 06:00 [pubmed]
PHST- 2011/05/24 06:00 [medline]
AID - 10.1002/ccd.22647 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2011 Feb 1;77(2):163-70. doi: 10.1002/ccd.22647.