Complete vs culprit-only revascularization for patients with multivessel disease undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: A systematic review and meta-analysis

摘要: Background Patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease who undergo primary percutaneous intervention (PCI) are most commonly treated PCI to the culprit lesion only. Whether a strategy of complete revascularization in these patients is superior unknown. We performed meta-analysis comparing benefits risks routine culprit-only vs STEMI. Methods MEDLINE, EMBASE, ISI Web Science, The Cochrane Register Controlled Trials were searched from 1996 January 2011. Relevant conference abstracts 2002 Studies included STEMI receiving PCI. end point was long-term mortality. Data combined using fixed-effects model. Results Of 507 citations, 26 studies (3 randomized, 23 nonrandomized; 46,324 patients, 7886 38,438 PCI) included. There no significant difference hospital mortality (odds ratio [OR] 1.11, 95% CI 0.98-1.25, P = .10 [randomized OR 0.24, 0.06-0.91, .04; nonrandomized 1.12, 1.00-1.27, .06]). However, if during index catheterization performed, increased (OR 1.35, 1.19-1.54, interaction .22; 0.75, 0.65-0.86, .01[randomized 0.31, 0.17-0.57, .54]) observed Conclusion Overall, staged improved short- survival reduced repeat Still, large randomized trials required confirm