Impact of percutaneous coronary intervention on chronic total occlusion in the non-infarct-related artery in patients with STEMI: a systematic review and meta-analysis.
Scand Cardiovasc J
; 56(1): 157-165, 2022 12.
Article
en En
| MEDLINE
| ID: mdl-35674511
ABSTRACT
OBJECTIVES:
We sought to compare the clinical outcomes between culprit-only percutaneous coronary intervention (PCI) versus multivessel PCI (MV-PCI) in patients with ST-segment elevation myocardial infarction (STEMI) accompanied by chronic total occlusion (CTO) in the non-infarct-related artery(non-IRA).DESIGN:
Studies that compared culprit-only PCI versus MV-PCI in patients with STEMI accompanied by CTO in the non-IRA were included. Random odds ratio (OR) and 95% confidence interval (CI) were calculated.RESULTS:
Eight studies with 2,259 patients were included. The results suggested that in patients with STEMI accompanied by CTO in the non-IRA, culprit-only PCI was associated with higher risks of all-cause mortality (OR 2.89; 95% CI 2.09-4.00; I2 = 0.0%), cardiac death (OR 3.12; 95% CI 2.05-4.75; I2 = 16.8%), stroke (OR 2.80; 95% CI 1.04-7.53; I2 = 0.0%), major adverse cardiovascular event (MACE; OR 2.06; 95% CI 1.39-3.06; I2 = 54.0%), and heart failure (OR 1.99; 95% CI 1.22-3.24; I2 = 0.0%) compared with staged MV-PCI, which were mainly derived from retrospective studies. No differences were observed in myocardial infarction or revascularization. Pooled multivariable adjusted results consistently indicated that staged MV-PCI was superior to culprit-only PCI.CONCLUSIONS:
For patients with STEMI accompanied by CTO in the non-IRA, staged MV-PCI may be better compared with culprit-only PCI due to potential reduced risks of all-cause mortality, cardiac death, stroke, MACE, and heart failure. Meanwhile, further randomized trials are warranted to confirm or refute our findings.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
/
Accidente Cerebrovascular
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Intervención Coronaria Percutánea
/
Infarto del Miocardio con Elevación del ST
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Insuficiencia Cardíaca
/
Infarto del Miocardio
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Scand Cardiovasc J
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
China