Complete versus culprit only revascularization in acute ST elevation myocardial infarction: a meta-analysis.

摘要: Background: Current guidelines recommend against the revascularization of noninfarct related artery (complete [CR]) in patients with ST elevation myocardial infarction (STEMI) and no hemodynamic compromise, though level evidence is C. Aim: Our aim was to examine available determine any advantage CR over culprit only (COR). Methods: We systematically searched medline using key words—“culprit coronary revascularization,” “complete infarction,” “multivessel STEMI” for studies reporting outcomes after COR versus during primary procedure or index hospitalization published English language indexed before February 2010. A random effect fixed meta-analysis, as applicable, performed RevMan 5 (Cochrane Center, Denmark). Results: Nine eligible nonrandomized amounting 4,530 27,323 group were included. In addition, two small randomized trials reviewed included secondary analysis. Majority hemodynamically stable. Major adverse cardiovascular events (Odds ratio [OR] = 0.95, 95% CI 0.47–1.90) long term mortality (OR 1.10, 0.76–1.59) similar. The marginal increased odds in-hospital derived from a single study difference found sensitivity cumulative analysis 1.21 0.85–1.73). Conclusion: heterogeneous did not reveal benefit STEMI. However, also provide conclusive hospital CR. trial needed confirm these findings recognize subgroup which might © 2010 Wiley-Liss, Inc.