PMID- 29779179
OWN - NLM
STAT- MEDLINE
DCOM- 20190418
LR  - 20190418
IS  - 1875-8312 (Electronic)
IS  - 1569-5794 (Linking)
VI  - 34
IP  - 9
DP  - 2018 Sep
TI  - Clinical outcomes of complete revascularization using either angiography-guided 
      or fractional flow reserve-guided drug-eluting stent implantation in non-culprit 
      vessels in ST elevation myocardial infarction patients: insights from a study 
      based on a systematic review and meta-analysis.
PG  - 1349-1364
LID - 10.1007/s10554-018-1362-9 [doi]
AB  - Current guidelines recommend that percutaneous coronary intervention (PCI) should 
      be restricted to the culprit vessel in ST elevation myocardial infarction (STEMI) 
      patients with multi-vessel disease (MVD) and without cardiogenic shock. However, 
      newer data suggests that performing complete revascularization (CR) in MVD 
      patients may lead to better outcomes compared to intervention in the culprit 
      vessel only. The aim of this meta-analysis is to examine the available data to 
      determine if CR (using either angio- or fractional flow reserve guidance-FFR) 
      following primary PCI in STEMI patients without cardiogenic shock impacts 
      clinical outcomes. Meta-analysis was performed by conducting a literature search 
      of PubMed from January 2004 to July 2017. Pooled estimates of outcomes, presented 
      as odds ratios (OR) [95% confidence intervals], were generated using 
      random-effect models. A total of 9 studies (3317 patients) were included. CR 
      showed a significant MACE reduction (OR 0.49, 95% CI 0.36-0.66, p < 0.001); 
      All-cause mortality (OR 0.69, 95% CI 0.48-0.98, p = 0.04) and repeat 
      revascularization (OR 0.38, 95% CI 0.28-0.51, p < 0.001) at >/= 12 months 
      follow-up. The FFR-guiding CR group presented a MACE reduction (odds ratio 0.52, 
      95% CI 0.30-0.90, p = 0.02) due to a decrease of repeat revascularization (OR 
      0.41, 95% CI 0.21-0.80, p = 0.009). Overall, performing complete 
      revascularization in STEMI patients showed a MACE reduction, all-cause death and 
      repeat revascularization. Compared to culprit-only revascularization, treating 
      multi-vessel disease in STEMI patients using FFR guidance is associated with 
      decreased incidence of MACE, due to a decreased rate of revascularization.
FAU - Hideo-Kajita, Alexandre
AU  - Hideo-Kajita A
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Garcia-Garcia, Hector M
AU  - Garcia-Garcia HM
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA. hector.m.garciagarcia@medstar.net.
FAU - Kuku, Kayode O
AU  - Kuku KO
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Beyene, Solomon S
AU  - Beyene SS
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Azizi, Viana
AU  - Azizi V
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Meirovich, Yael F
AU  - Meirovich YF
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Melaku, Gebremedhin D
AU  - Melaku GD
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Dheendsa, Aaphtaab
AU  - Dheendsa A
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Brathwaite, Echo J
AU  - Brathwaite EJ
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Desale, Sameer
AU  - Desale S
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Soud, Mohammad
AU  - Soud M
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Dan, Kazuhiro
AU  - Dan K
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Ozaki, Yuichi
AU  - Ozaki Y
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Waksman, Ron
AU  - Waksman R
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
FAU - Lipinski, Michael
AU  - Lipinski M
AD  - Division of Interventional Cardiology, MedStar Cardiovascular Research Network, 
      MedStar Washington Hospital Center, 110 Irving Street, East Building, Suite 4B-1, 
      Washington, DC, 20010, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20180519
PL  - United States
TA  - Int J Cardiovasc Imaging
JT  - The international journal of cardiovascular imaging
JID - 100969716
SB  - IM
MH  - Coronary Angiography
MH  - Coronary Artery Disease/complications/diagnostic imaging/physiopathology/*therapy
MH  - *Drug-Eluting Stents
MH  - Fractional Flow Reserve, Myocardial
MH  - Humans
MH  - Myocardial Revascularization/*methods
MH  - *Percutaneous Coronary Intervention
MH  - ST Elevation Myocardial Infarction/diagnostic 
      imaging/etiology/physiopathology/*therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Drug-eluting stent
OT  - Fractional flow reserve
OT  - Meta-analysis
OT  - STEMI complete revascularization
OT  - Systematic review
EDAT- 2018/05/21 06:00
MHDA- 2019/04/19 06:00
CRDT- 2018/05/21 06:00
PHST- 2018/03/02 00:00 [received]
PHST- 2018/04/20 00:00 [accepted]
PHST- 2018/05/21 06:00 [pubmed]
PHST- 2019/04/19 06:00 [medline]
PHST- 2018/05/21 06:00 [entrez]
AID - 10.1007/s10554-018-1362-9 [pii]
AID - 10.1007/s10554-018-1362-9 [doi]
PST - ppublish
SO  - Int J Cardiovasc Imaging. 2018 Sep;34(9):1349-1364. doi: 
      10.1007/s10554-018-1362-9. Epub 2018 May 19.