Background: There are controversial data regarding infarct-related artery only (IRA-PCI) revascularisation versus multivessel revascularisation (MV-PCI) in ST-elevation myocardial infarction (STEMI) patients with multivessel disease undergoing primary percutaneous coronary intervention (PCI). We performed a meta-analysis comparing outcome in same stage MV-PCI versus IRA-PCI in STEMI patients with multivessel disease.
Methods: Systematic searches of studies comparing MV-PCI with IRA-PCI in the MEDLINE and the Cochrane Database of systematic reviews were conducted. A meta-analysis was performed of all available studies. Primary outcome was all-cause mortality. Secondary endpoints were re-infarction, revascularisation, bleeding and major adverse cardiac events (MACE).
Results: A total of 15 studies were identified with a total number of 35,975 patients. Mortality rate was significantly higher in the MV-PCI group compared with the IRA-PCI group, odds ratio (OR): 1.64 (1.46-1.85). Both the incidence of re-infarction and re-PCI were significantly lower in the MV-PCI group compared with the IRA-PCI group: OR 0.54 (0.34-0.88) and OR 0.67 (0.48-0.93), respectively. Bleeding complications occurred more often in the MV-PCI group as compared with the IRA-PCI group: OR 1.24 (1.08-1.42). Rates of MACE were comparable between the two groups.
Conclusions: MV-PCI during the index of primary PCI in STEMI patients is associated with a higher mortality rate, a higher risk of bleeding complications, but lower risk of re-intervention and re-infarction and comparable rates of MACE.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368524 | PMC |
| http://dx.doi.org/10.1007/s12471-015-0674-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Whodunnit: Anterior ST-Elevation Myocardial Infarction in a Patient Found to Have Apparent Takotsubo Cardiomyopathy, Left Anterior Descending Artery Disease, and Myocardial Bridging.
Cureus
December 2024
Department of Cardiovascular Medicine, University of Texas Health Science Center at Houston, Houston, USA.
We present a case of a 52-year-old male with no known past medical history who presented to an outside hospital with acute chest pain. Initial workup revealed anteroseptal ST-elevation myocardial infarction (STEMI) for which the patient was transferred to our facility for emergent percutaneous coronary intervention (PCI). However, the patient's hospital course revealed numerous confounding pathologies that can also present as STEMI, including transthoracic echocardiogram (TTE) abnormalities consistent with takotsubo cardiomyopathy (TCM) as well as myocardial bridging presenting as post-PCI STEMI in the setting of nitroglycerin use.
View Article and Find Full Text PDFThe guide extension-facilitated ostial stenting (GEST) technique uses a guide extension catheter (GEC) to improve stent delivery during primary coronary angioplasty (PCI). GECs are used for stent delivery into the coronary arteries of patients with difficult anatomy due to tortuosity, calcification, or chronic total occlusion (CTO) vessels. Stent and balloon placement has become challenging in patients with increasing lesion complexity due to tortuosity, vessel morphology, length of the lesion, and respiratory movements.
View Article and Find Full Text PDFExpedited Conveyance of Out-of-Hospital-Cardiac Arrest patients with STEMI and shockable rhythms to Cardiac Arrest Centres - A Feasibility Pilot Study of the British Cardiovascular Intervention Society conveyance algorithm.
Resuscitation
January 2025
Essex Cardiothoracic centre, MSE Trust, Basildon, Essex, UK; MTRC, Anglia Ruskin School of Medicine, Chelmsford, Essex, UK. Electronic address:
Background And Aims: Guidelines suggest non-traumatic out-of-hospital cardiac arrest (OHCA) be conveyed to cardiac arrest centres (CAC). We hypothesised that (a) a pre-hospital conveyance algorithm based on initial presenting rhythm following OHCA is feasible and (b) that would demonstrate survival advantage.
Methods: This observational pilot study included all consecutive patients with OHCA from suspected cardiac aetiology from the county of Essex, United Kingdom from April 2022-April 2023.
A 36-year-old woman with ulcerative colitis presented with progressive chest pain and neurovegetative symptoms. The electrocardiogram showed ST segment elevation in the inferior wall. The patient had a previous history of fatigue and night sweats.
View Article and Find Full Text PDFRed Cell Distribution Width as a Marker of Disease Severity and In-hospital Mortality in Patients with ST-segment Elevation Myocardial Infarction.
Indian J Crit Care Med
December 2024
Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India.
Background: The red cell distribution width (RDW) has been investigated as a predictive factor for complications and mortality in several critical illnesses, including cardiovascular diseases.
Objective: The current study aimed to assess the relationship of RDW with severity and in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI).
Materials And Methods: A prospective hospital-based observational study was conducted at a tertiary care institute of Northern India.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!