Impact of complete versus culprit-only revascularization on major adverse cardiovascular event in diverse subpopulations.

Autor: Ansari HUH; Department of Internal Medicine, Dow University of Health Sciences, Pakistan., Dar FN; Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan., Shaikh N; Department of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Noman A; Department of Internal Medicine, Dow University of Health Sciences, Pakistan., Ahmed K; Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan., Asad U; Department of General Surgery, Nawaz Sharif Medical College, Lahore, Pakistan., Khalid K; Department of Medicine, University of Health Sciences, Lahore, Pakistan., Ahmed M; Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan., Zakarya A; Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan., Leel U; Department of Infectious Disease, University Hospital Limerick, Dooradoyle, Ireland., Shaikh RA; Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan., Abbas K; Department of Medicine, Agha Khan University, Karachi, Pakistan.
Jazyk: angličtina
Zdroj: Future cardiology [Future Cardiol] 2024; Vol. 20 (11-12), pp. 627-637. Date of Electronic Publication: 2024 Sep 04.
DOI: 10.1080/14796678.2024.2387516
Abstrakt: Background: Myocardial infarction management relies on pharmaceuticals and interventions like percutaneous coronary intervention (PCI). While complete PCI has shown noninferiority to culprit-only PCI, its impact on major adverse cardiovascular events (MACE) outcomes in multiple subpopulations has been unknown. Methods: A systematic literature search (from January 2000 to May 2024) identified four relevant randomized controlled trials involving ST-segment elevation myocardial infarction patients. Data analysis employed a random-effects model with inverse variance weighting. Results: MACE risk was significantly lower in males than females undergoing complete PCI compared with culprit-only PCI (hazard ratio: 0.52; 95% CI: 0.39-0.68; p  < 0.01; I2 = 53%). Furthermore, complete PCI significantly lowered the risk of MACE outcomes in patients without diabetes and in patients under the 65-year age limit in comparison to culprit-only PCI. Conclusion: Complete PCI reduces MACE risk in male, nondiabetic ST-segment elevation myocardial infarction patients under 65 with multivessel coronary artery disease, necessitating further investigation into outcome differences among different subpopulations.
Databáze: MEDLINE