PMID- 25453403
OWN - NLM
STAT- MEDLINE
DCOM- 20150820
LR  - 20181202
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 179
DP  - 2015 Jan 20
TI  - Management of multivessel coronary disease in STEMI patients: a systematic review 
      and meta-analysis.
PG  - 552-7
LID - S0167-5273(14)01972-X [pii]
LID - 10.1016/j.ijcard.2014.10.035 [doi]
AB  - BACKGROUND: Appropriate management for patients with multivessel coronary disease 
      presenting with ST segment Elevation Myocardial Infarction (STEMI) remains to be 
      defined. METHODS AND RESULTS: Medline and Cochrane Library were searched for 
      randomized controlled trials (RCTs) or observational studies adjusted with 
      multivariate analysis, reporting about STEMI patients with multivessel coronary 
      disease treated with either a culprit only or complete revascularization 
      strategy, excluding patients in cardiogenic shock. Prespecified analysis was 
      performed according to the strategy of complete revascularization, either during 
      the same procedure of primary percutaneous coronary intervention (PCI) or during 
      the index hospitalization. MACE (a composite and mutually exclusive end point of 
      death or myocardial infarction or revascularization) at follow-up of at least one 
      year was the primary end point. 9 studies with 4686 patients compared culprit 
      only versus complete PCI performed during the primary PCI. Rates of MACE did not 
      differ at 90 days (OR 0.70 [0.38, 1.27], I(2)=0%) or at 1 year (1-2.5) (OR 0.70 
      [0.47, 1.03], I(2)=0%). No significant difference was found for the components of 
      the primary outcome, apart from a reduction in repeated revascularization for 
      patients undergoing complete PCI during the STEMI procedure (OR 0.62 [0.39, 
      0.98], I(2)=0%). 6 studies (1 RCT) with 5855 patients compared culprit only 
      lesions versus complete PCI performed during index hospitalization. 90 day risk 
      of MACE did not differ nor 1 year (1-2.5) MACE (OR 0.86 [0.62, 1.08], I(2)=0%), 
      with a similar reduction in repeated revascularization (0.60 [0.40, 0.90], 
      I(2)=0%). CONCLUSIONS: Complete revascularization performed during primary PCI or 
      index hospitalizations for patients presenting with STEMI appears safe at short 
      term follow-up and offers a reduction in repeated revascularization at one year.
CI  - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved.
FAU - Moretti, Claudio
AU  - Moretti C
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy.
FAU - D'Ascenzo, Fabrizio
AU  - D'Ascenzo F
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy. Electronic address: 
      fabrizio.dascenzo@gmail.com.
FAU - Quadri, Giorgio
AU  - Quadri G
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy.
FAU - Omede, Pierluigi
AU  - Omede P
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy.
FAU - Montefusco, Antonio
AU  - Montefusco A
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy.
FAU - Taha, Salma
AU  - Taha S
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy.
FAU - Cerrato, Enrico
AU  - Cerrato E
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy.
FAU - Colaci, Chiara
AU  - Colaci C
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy.
FAU - Chen, Shao-Liang
AU  - Chen SL
AD  - Nanjing Medical University, Nanjing, China.
FAU - Biondi-Zoccai, Giuseppe
AU  - Biondi-Zoccai G
AD  - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University 
      of Rome, Piazzale Aldo Moro, Rome, Italy.
FAU - Gaita, Fiorenzo
AU  - Gaita F
AD  - Division of Cardiology, Department of Internal Medicine, Citta Della Salute e 
      Della Scienza, University of Turin, Italy.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20141022
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Coronary Disease/mortality/*therapy
MH  - Humans
MH  - Myocardial Infarction/mortality/*therapy
MH  - Myocardial Revascularization/*methods
MH  - Percutaneous Coronary Intervention/*methods
MH  - Risk Assessment
OTO - NOTNLM
OT  - Complete revascularization
OT  - Multivessel disease
OT  - STEMI
EDAT- 2014/12/03 06:00
MHDA- 2015/08/21 06:00
CRDT- 2014/12/03 06:00
PHST- 2014/02/14 00:00 [received]
PHST- 2014/08/04 00:00 [revised]
PHST- 2014/10/18 00:00 [accepted]
PHST- 2014/12/03 06:00 [entrez]
PHST- 2014/12/03 06:00 [pubmed]
PHST- 2015/08/21 06:00 [medline]
AID - S0167-5273(14)01972-X [pii]
AID - 10.1016/j.ijcard.2014.10.035 [doi]
PST - ppublish
SO  - Int J Cardiol. 2015 Jan 20;179:552-7. doi: 10.1016/j.ijcard.2014.10.035. Epub 
      2014 Oct 22.