Journal of Thrombosis and Thrombolysis

, Volume 31, Issue 2, pp 217–225 | Cite as

Clinical impact of simultaneous complete revascularization vs. culprit only primary angioplasty in patients with st-elevation myocardial infarction and multivessel disease: a meta-analysis

  • Eliano Pio Navarese
  • Stefano De Servi
  • Antonino Buffon
  • Harry Suryapranata
  • Giuseppe De Luca
Article

Abstract

Primary Percutaneous Intervention (PCI) is the treatment of choice for acute ST-elevation myocardial infarction (STEMI). Nearly half of STEMI patients have multivessel (MV) disease that has been associated with worse survival. However, current guidelines recommend to treat only the culprit artery (COR) during the acute procedure. Thus, the aim of the current study was to perform a meta-analysis of trials comparing MV PCI vs. COR for STEMI patients with MV disease. Medline/CENTRAL and Web were searched for comparative studies (both randomized and non randomized trials) about MV PCI vs. COR for STEMI patients reporting mortality, re-PCI and re-MI data. Primary endpoint was 30-day mortality. The meta-analysis included 10 studies (2 randomized and 8 registries; N = 31224). As compared with COR, MV PCI significantly reduced long term rate of re-PCI (OR [95% CI] = 0.47 [0.28–0.78], P = 0.003) without increasing 30-day mortality (OR [95% CI] = 1.30 [0.79–2.12], P = 0.31) and long term re-MI (OR [95% CI] = 0.94 [0.43–2.06], P = 0.88). This meta-analysis showed safety and efficacy of MV PCI approach as compared with COR, with a significant reduction in rate of revascularizations, but no advantages in death and re-MI.

Keywords

ST-elevation myocardial infarction Primary angioplasty Multivessel disease Meta-analysis 

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Eliano Pio Navarese
    • 1
  • Stefano De Servi
    • 2
  • Antonino Buffon
    • 3
  • Harry Suryapranata
    • 4
  • Giuseppe De Luca
    • 1
    • 5
  1. 1.Division of Cardiology, Ospedale “Maggiore della Carità”Eastern Piedmont UniversityNovaraItaly
  2. 2.Department of Cardiovascular DiseasesCivic HospitalLegnanoItaly
  3. 3.Department of CardiologyCatholic University of Sacred HeartRomeItaly
  4. 4.Division of CardiologyDe Weezenlanden HospitalZwolleThe Netherlands
  5. 5.Chief Interventional Cardiology, Ospedale “Maggiore della Carità”Eastern Piedmont UniversityNovaraItaly

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