PMID- 25332779
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20210129
LR  - 20211021
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 1
IP  - 1
DP  - 2014
TI  - Preventive PCI versus culprit lesion stenting during primary PCI in acute STEMI: 
      a systematic review and meta-analysis.
PG  - e000012
LID - 10.1136/openhrt-2013-000012 [doi]
LID - e000012
AB  - AIM: The benefit of preventive percutaneous coronary intervention (PCI) in ST 
      elevation myocardial infarction (STEMI) has been shown in randomised trials. 
      However, all the randomised trials are underpowered to detect benefit in cardiac 
      death. We aim to systematically review evidence on the cardiac mortality benefit 
      of preventive PCI in patients presenting with acute STEMI in randomised patient 
      populations. METHODS: PubMed, Scopus, Cochrane and clinicaltrials.gov databases 
      were searched for studies published until 30 September 2013. The studies were 
      limited to randomised clinical trials. Independent observers abstracted the data 
      on outcomes, characteristics and qualities of studies included. Fixed effect 
      model was employed for meta-analysis. Heterogeneity of studies included was 
      analysed using I(2) statistics. RESULTS: In three randomised clinical trials 
      published, involving 748 patients with acute STEMI and multivessel disease, 416 
      patients were randomised to preventive PCI and 332 to culprit-only PCI. Patients 
      undergoing preventive PCI had significant lower risk of cardiovascular deaths 
      (pooled OR 0.39, 95% CI 0.18 to 0.83, p=0.01, I(2)=0%), repeat revascularisation 
      (pooled OR 0.28, 95% CI 0.18 to 0.44, p=0.00001, I(2)=0%) and non-fatal 
      myocardial infarction (pooled OR 0.38, 95% CI 0.20 to 0.75, p=0.005, I(2)=0%) 
      compared with culprit-only revascularisation. CONCLUSIONS: In patients presenting 
      with acute STEMI and significant multivessel coronary artery disease, based on 
      our data, preventive PCI is associated with lower risk of cardiovascular 
      mortality compared with primary PCI of only the culprit artery. This finding 
      needs to be confirmed in larger adequately powered randomised clinical trials.
FAU - Pandit, Anil
AU  - Pandit A
AD  - Division of Cardiovascular Diseases , Mayo Clinic , Scottsdale, Arizona , USA.
FAU - Aryal, Madan Raj
AU  - Aryal MR
AD  - Department of Internal Medicine , Reading Hospital , West Reading, Pennsylvania , 
      USA.
FAU - Aryal Pandit, Aashrayata
AU  - Aryal Pandit A
AD  - Division of Cardiovascular Diseases , Mayo Clinic , Scottsdale, Arizona , USA.
FAU - Hakim, Fayaz Ahmad
AU  - Hakim FA
AD  - Division of Cardiovascular Diseases , Mayo Clinic , Scottsdale, Arizona , USA.
FAU - Giri, Smith
AU  - Giri S
AD  - Department of Internal Medicine , University of Tennessee , Memphis, Tennessee , 
      USA.
FAU - Mainali, Naba Raj
AU  - Mainali NR
AD  - Department of Internal Medicine , Reading Hospital , West Reading, Pennsylvania , 
      USA.
FAU - Sharma, Prashant
AU  - Sharma P
AD  - Department of Internal Medicine , Mayo Clinic , Rochester, Minnesota , USA.
FAU - Lee, Howard R
AU  - Lee HR
AD  - Division of Cardiovascular Diseases , Mayo Clinic , Scottsdale, Arizona , USA.
FAU - Fortuin, F David
AU  - Fortuin FD
AD  - Division of Cardiovascular Diseases , Mayo Clinic , Scottsdale, Arizona , USA.
FAU - Mookadam, Farouk
AU  - Mookadam F
AD  - Division of Cardiovascular Diseases , Mayo Clinic , Scottsdale, Arizona , USA.
LA  - eng
PT  - Journal Article
DEP - 20140215
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
PMC - PMC4189298
OTO - NOTNLM
OT  - Coronary Artery Disease
EDAT- 2014/10/22 06:00
MHDA- 2014/10/22 06:01
PMCR- 2014/02/15
CRDT- 2014/10/22 06:00
PHST- 2013/12/03 00:00 [received]
PHST- 2014/01/22 00:00 [revised]
PHST- 2014/01/25 00:00 [accepted]
PHST- 2014/10/22 06:00 [entrez]
PHST- 2014/10/22 06:00 [pubmed]
PHST- 2014/10/22 06:01 [medline]
PHST- 2014/02/15 00:00 [pmc-release]
AID - openhrt-2013-000012 [pii]
AID - 10.1136/openhrt-2013-000012 [doi]
PST - epublish
SO  - Open Heart. 2014 Feb 15;1(1):e000012. doi: 10.1136/openhrt-2013-000012. 
      eCollection 2014.