PMID- 32571757
OWN - NLM
STAT- MEDLINE
DCOM- 20210812
LR  - 20210812
IS  - 1878-0938 (Electronic)
IS  - 1878-0938 (Linking)
VI  - 21
IP  - 12
DP  - 2020 Dec
TI  - Complete Versus Culprit-Only Revascularization in Patients Presenting With 
      ST-Segment Elevation Myocardial Infarction: A Meta-Analysis of Randomized Control 
      Trials.
PG  - 1482-1488
LID - S1553-8389(20)30291-8 [pii]
LID - 10.1016/j.carrev.2020.05.019 [doi]
AB  - BACKGROUND: In patients with ST elevation myocardial infarction (STEMI), primary 
      percutaneous coronary intervention (PCI) of the culprit vessel is the preferred 
      treatment option. For patients with multivessel disease, the benefit of 
      revascularization of the non-culprit artery is not well known. This meta-analysis 
      aims to assess the efficacy and safety of complete versus culprit vessel only 
      revascularization. METHODS: Randomized control trials (RCT) that compared 
      head-to-head complete versus culprit-vessel only revascularization in STEMI 
      patients and reported main outcomes of interest such as mortality, myocardial 
      infarction, and revascularization, were included in this meta-analysis. RESULTS: 
      We found ten RCTs satisfying our inclusion criteria. Data was extracted and used 
      to estimate the risk ratio (RR) and 95% confidence interval (CI) for dichotomous 
      variables. Our study included 7030 patients (3426 complete revascularization, and 
      3604 culprit-only revascularization). Complete revascularization (CR) (both 
      immediate and staged) significantly reduced the risk of MACE compared with 
      culprit only (CO) revascularization (10.7% vs 20.1%, RR 0.53; 95% CI 0.43 to 
      0.64; P < 0.0001), reinfarction (5.0% vs 6.9%, RR 0.69; 95 CI 0.51 to 0.93; 
      P < 0.01), and revascularization (4.2% vs 12.7%, RR 0.37; 95 CI 0.26 to 0.54; 
      P < 0.0001). Our analysis did not find any significant difference in all-cause 
      mortality between CR and CO (4.6% vs 5.0%, RR 0.89; 95 CI 0.72 to 0.1.10; 
      P = 0.27). CONCLUSION: In conclusion, complete revascularization was associated 
      with a significant reduction in major adverse cardiovascular events, 
      revascularization and reinfarction.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Salih, Mohsin
AU  - Salih M
AD  - Division of Cardiology, Southern Illinois University School of Medicine, United 
      States of America. Electronic address: msalih29@siumed.edu.
FAU - Ibrahim, Abdisamad M
AU  - Ibrahim AM
AD  - Department of Internal Medicine, Southern Illinois University School of Medicine, 
      United States of America.
FAU - Al-Akchar, Mohammad
AU  - Al-Akchar M
AD  - Division of Cardiology, Southern Illinois University School of Medicine, United 
      States of America.
FAU - Bhattarai, Mukul
AU  - Bhattarai M
AD  - Division of Cardiology, Southern Illinois University School of Medicine, United 
      States of America.
FAU - Koester, Cameron
AU  - Koester C
AD  - Department of Internal Medicine, Southern Illinois University School of Medicine, 
      United States of America.
FAU - Ayan, Mohamed
AU  - Ayan M
AD  - Department of Cardiovascular Medicine, University of Arkansas for Medical 
      Sciences, United States of America.
FAU - Hafiz, Abdul Moiz
AU  - Hafiz AM
AD  - Division of Cardiology, Southern Illinois University School of Medicine, United 
      States of America.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20200521
PL  - United States
TA  - Cardiovasc Revasc Med
JT  - Cardiovascular revascularization medicine : including molecular interventions
JID - 101238551
SB  - IM
MH  - *Coronary Artery Disease
MH  - Humans
MH  - Myocardial Revascularization
MH  - Odds Ratio
MH  - Percutaneous Coronary Intervention
MH  - Randomized Controlled Trials as Topic
MH  - *ST Elevation Myocardial Infarction
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Complete revascularization
OT  - Culprit-only revascularization
OT  - Meta-analysis
OT  - Myocardial infarction
OT  - Percutaneous coronary intervention
OT  - STEMI
EDAT- 2020/06/24 06:00
MHDA- 2021/08/13 06:00
CRDT- 2020/06/24 06:00
PHST- 2020/01/21 00:00 [received]
PHST- 2020/05/13 00:00 [revised]
PHST- 2020/05/18 00:00 [accepted]
PHST- 2020/06/24 06:00 [pubmed]
PHST- 2021/08/13 06:00 [medline]
PHST- 2020/06/24 06:00 [entrez]
AID - S1553-8389(20)30291-8 [pii]
AID - 10.1016/j.carrev.2020.05.019 [doi]
PST - ppublish
SO  - Cardiovasc Revasc Med. 2020 Dec;21(12):1482-1488. doi: 
      10.1016/j.carrev.2020.05.019. Epub 2020 May 21.