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Staged versus One-Time Complete Revascularization with Percutaneous Coronary Intervention in STEMI Patients with Multivessel Disease: A Systematic Review and Meta-Analysis

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  • Zhenwei Li
  • Yijiang Zhou
  • Qingqing Xu
  • Xiaomin Chen

Abstract

Introduction: In patients with acute ST-elevation myocardial infarction (STEMI), the preferred intervention is percutaneous coronary intervention (PCI).Whether staged PCI (S-PCI) or one-time complete PCI (MV-PCI) is more beneficial and safer in terms of treating the non-culprit vessel during the primary PCI procedure is unclear. We performed a meta-analysis of all randomized and non-randomized controlled trials comparing S-PCI with MV-PCI in patients with acute STEMI and MVD. Methods: Studies of STEMI with multivessel disease receiving primary PCI were searched in PUBMED, EMBASE and The Cochrane Register of Controlled Trials from January 2004 to December 2014. The primary end points were long-term rates of major adverse cardiovascular events and their components—mortality, reinfarction, and target-vessel revascularization. Data were combined using a fixed-effects model. Results: Of 507 citations, 10 studies (4 randomized, 6 nonrandomized; 820 patients, 562 staged PCI and 347 one-time, complete multi-vessel PCI) were included. S-PCI compared to MV-PCI significantly reduced mortality both long-term (OR 0.44, 95% CI 0.29–0.66, P

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  • Zhenwei Li & Yijiang Zhou & Qingqing Xu & Xiaomin Chen, 2017. "Staged versus One-Time Complete Revascularization with Percutaneous Coronary Intervention in STEMI Patients with Multivessel Disease: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-15, January.
    • Handle: RePEc:plo:pone00:0169406
    DOI: 10.1371/journal.pone.0169406
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    Cited by:

    1. Seghieri, Chiara & Berta, Paolo & Nuti, Sabina, 2019. "Geographic variation in inpatient costs for Acute Myocardial Infarction care: Insights from Italy," Health Policy, Elsevier, vol. 123(5), pages 449-456.

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