A comparison of multivessel and culprit vessel percutaneous coronary intervention in non-ST-segment elevation acute coronary syndrome patients with multivessel disease: a meta-analysis
| Autor: | Xin Du, Wei-ju Li, Changsheng Ma, Salim Mohamed, Shaoping Nie, Xiao-hui Liu, Yan Qiao, Yin Zhang, Xiao Wang, Chang-qi Jia |
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| Rok vydání: | 2015 |
| Předmět: |
Acute coronary syndrome
medicine.medical_specialty business.industry medicine.medical_treatment Myocardial Infarction Percutaneous coronary intervention Odds ratio medicine.disease Culprit Percutaneous Coronary Intervention Treatment Outcome Internal medicine Conventional PCI medicine Cardiology Odds Ratio ST segment Humans cardiovascular diseases Myocardial infarction Acute Coronary Syndrome Mortality Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 11(5) |
| ISSN: | 1969-6213 |
| Popis: | Aims Percutaneous revascularisation triage has not been evaluated in randomised controlled trials of patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) and multivessel disease. As a result, current guidelines are not available. The objective of our meta-analysis was to investigate the use of percutaneous coronary intervention (PCI) in culprit and non-culprit vessels. Methods and results We undertook a meta-analysis of controlled studies where patients were assigned to multivessel PCI or culprit vessel PCI. Summary odds ratios (OR) for all-cause mortality, myocardial infarction, unplanned revascularisation and major adverse cardiac events (MACE) were calculated using random- or fixed-effect models. Six registry studies (n=5,414) were included in this meta-analysis. There was no difference in the rate of mortality (OR, 0.85; 95% CI: 0.70 to 1.04; p=0.114) or myocardial infarction (OR, 0.75; 95% CI: 0.43 to 1.32; p=0.319) between the two treatment groups. Multivessel PCI may decrease long-term MACE (OR, 0.69; 95% CI: 0.51 to 0.93; p=0.015) and unplanned revascularisation (OR, 0.64; 95% CI: 0.45 to 93; p=0.018) compared with culprit vessel PCI. Conclusions No significant difference was demonstrated in the long-term risk of myocardial infarction and mortality between multivessel PCI and culprit vessel PCI. Therefore, multivessel PCI may be a safe and reasonable option for NSTE-ACS patients with multivessel disease. |
| Databáze: | OpenAIRE |
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