PMID- 26524970
OWN - NLM
STAT- MEDLINE
DCOM- 20170321
LR  - 20170817
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 88
IP  - 4
DP  - 2016 Oct
TI  - Complete Versus Culprit-Only Revascularization for Patients With Multi-Vessel 
      Disease Undergoing Primary Percutaneous Coronary Intervention: An Updated 
      Meta-Analysis of Randomized Trials.
PG  - 501-505
LID - 10.1002/ccd.26322 [doi]
AB  - OBJECTIVES: To perform an updated meta-analysis to determine whether complete 
      revascularization of significant coronary lesions at the time of primary 
      percutaneous coronary intervention (PCI) would be associated with better outcomes 
      compared with culprit-only revascularization. BACKGROUND: Individual trials have 
      demonstrated conflicting evidence regarding the optimum revascularization 
      strategy at the time of primary PCI. METHODS: Clinical trials that randomized ST 
      elevation myocardial infarction (STEMI) patients with multi-vessel disease to a 
      complete versus culprit-only revascularization strategy were included. Random 
      effects summary risk ratios (RR) were constructed using a DerSimonian-Laird 
      model. The primary outcome of interest was mortality or myocardial infarction 
      (MI). RESULTS: A total of seven trials with 1,939 patients were included in the 
      analysis. Compared with culprit-only revascularization, complete 
      revascularization was associated with a non-significant reduction in the risk of 
      mortality or MI (RR 0.69, 95% confidence interval (CI) 0.42-1.12, P = 0.14). 
      Complete revascularization was associated with a reduced risk of major adverse 
      cardiac events (MACE) (RR 0.61, 95% CI 0.45-0.81, P < 0.001), due to a 
      significant reduction in urgent revascularization (RR 0.46, 95% CI 0.29-0.70, 
      P < 0.001). The risk of major bleeding and contrast-induced nephropathy was 
      similar with both approaches (RR 0.83, 95% CI 0.41-1.71, P = 0.62, and RR 0.94, 
      95% CI 0.42-2.12, P = 0.82). CONCLUSIONS: Complete revascularization of all 
      significant coronary lesions at the time of primary PCI was associated with a 
      reduction in the risk of MACE due to reduction in the risk of urgent 
      revascularization. This approach appears to be safe, with no excess major 
      bleeding, or contrast-induced nephropathy. (c) 2015 Wiley Periodicals, Inc.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Elgendy, Islam Y
AU  - Elgendy IY
AD  - Department of Medicine, University of Florida, Gainesville, Florida.
FAU - Wen, Xuerong
AU  - Wen X
AD  - Department of Medicine, University of Florida, Gainesville, Florida.
FAU - Mahmoud, Ahmed
AU  - Mahmoud A
AD  - Department of Medicine, University of Florida, Gainesville, Florida.
FAU - Bavry, Anthony A
AU  - Bavry AA
AD  - Department of Medicine, University of Florida, Gainesville, Florida. 
      anthony.bavry@va.gov.
AD  - North Florida/South Georgia Veterans Health Systems, Gainesville, Florida. 
      anthony.bavry@va.gov.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20151103
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
RN  - 0 (Contrast Media)
SB  - IM
CIN - Catheter Cardiovasc Interv. 2016 Oct;88(4):506-507. PMID: 27759928
MH  - Aged
MH  - Contrast Media/adverse effects
MH  - Coronary Angiography/adverse effects
MH  - Coronary Artery Disease/diagnostic imaging/mortality/*therapy
MH  - Female
MH  - Hemorrhage/etiology
MH  - Humans
MH  - Kidney Diseases/chemically induced
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Percutaneous Coronary Intervention/adverse effects/*methods/mortality
MH  - Randomized Controlled Trials as Topic
MH  - Recurrence
MH  - Risk Assessment
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/diagnostic imaging/mortality/*therapy
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - meta-analysis
OT  - myocardial infarction
OT  - percutaneous coronary intervention
EDAT- 2016/10/21 06:00
MHDA- 2017/03/23 06:00
CRDT- 2015/11/04 06:00
PHST- 2015/10/05 00:00 [received]
PHST- 2015/10/09 00:00 [accepted]
PHST- 2016/10/21 06:00 [pubmed]
PHST- 2017/03/23 06:00 [medline]
PHST- 2015/11/04 06:00 [entrez]
AID - 10.1002/ccd.26322 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2016 Oct;88(4):501-505. doi: 10.1002/ccd.26322. Epub 
      2015 Nov 3.