Meta-Analysis Comparing Same-Sitting and Staged Percutaneous Coronary Intervention of Non-Culprit Artery for ST-Elevation Myocardial Infarction with Multivessel Coronary Disease.

Autor: Ueyama H; Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York; Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York., Kuno T; Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York., Yasumura K; Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York., Vengrenyuk Y; Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York., Takagi H; Division of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan., Barman N; Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York., Suleman J; Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York., Banning AS; Department of Cardiovascular Sciences, University of Leicester and Cardiovascular Theme, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom., Boxma-de Klerk BM; Department of Cardiology, Maasstad Ziekenhuis, Rotterdam, Netherlands., Smits PC; Department of Cardiology, Maasstad Ziekenhuis, Rotterdam, Netherlands., Kini A; Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York. Electronic address: annapoorna.kini@mountsinai.org., Sharma SK; Division of Cardiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2021 Jul 01; Vol. 150, pp. 24-31. Date of Electronic Publication: 2021 May 16.
DOI: 10.1016/j.amjcard.2021.03.043
Abstrakt: Recent trials and meta-analysis have indicated that complete revascularization (CR) of multivessel coronary disease is beneficial in patients with ST-segment elevation myocardial infarction (STEMI) compared to culprit-only intervention. However, the optimal timing of CR remains unclear. We aimed to analyze the optimal timing of CR in patients with STEMI and multivessel disease by performing an updated network meta-analysis using the recent largest randomized controlled trial. PUBMED and EMBASE were searched through October 2020 to identify randomized controlled trials comparing CR and culprit-only revascularization. A random-effect network meta-analysis comparing three arms (same-sitting [during the index procedure] CR versus staged CR versus culprit-only) and 4 arms (same-sitting CR versus staged CR [in-hospital] versus staged CR [out-hospital] versus culprit-only) were performed. Eleven studies with a total of 7,015 patients were included in our analysis. There was no significant difference in major adverse cardiovascular event (MACE) (HR 0.82, 95% CI 0.64-1.05), cardiovascular death (HR 0.69, 95%CI 0.35-1.33), myocardial infarction (HR 0.66, 95%CI 0.37-1.16), and revascularization (HR 1.05, 95%CI 0.70-1.58) between same-sitting CR and staged CR. When staged CR was further divided into staged CR during the hospitalization and after discharge, there was no significant difference in these outcomes between staged CR (in-hospital) and staged CR (out-hospital). In conclusion, in patients with multivessel disease presenting with STEMI, complete revascularization at any timing, including same-sitting, staged in-hospital, and staged out-hospital, may have similar benefits.
Competing Interests: Conflict of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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