Meta-analysis of the effect of complete revascularization on the prognosis of patients with acute ST-segment elevation myocardial infarction complicated with multivessel disease
Yan Guangdong
Wu Fan
Yang Hui
Li Biao
Abstract：To evaluate the clinical efficacy of complete revascularization for the patients suffering from acute ST-segment elevated myocardial infarction complicated with multivessel disease. Methods The databases searched included PubMed, Embase, Cochrane Library, CBM, CNKI, Wanfang Database. Randomized controlled trials (RCTs) about the prognosis of complete revascularization versus culprit coronary intervention were included. All selected RCTs were screened by 2 reviewers according to inclusion and exclusion criteria. After extracting data and quality evaluation, meta-analysis was conducted by using RevMan 5.3 software. Results There were 11 included RCTs with 3697 cases, 1675 in complete revascularization group and 2022 in culprit coronary intervention group. The result of meta analysis showed that, compared with the culprit coronary intervention group, the incidence about major cardiovascular events (MACE) (RR=0.53, 95%CI: 0.42~0.69, P<0.001), cardiovascular mortality (RR=0.46, 95%CI: 0.30~0.71, P<0.001), all-cause mortality (RR=0.68, 95%CI: 0.50~0.92, P=0.01), and repeat revascularization (RR=0.38, 95%CI: 0.31~0.47, P<0.001) in the complete revascularization group were lower. The remyocardial infarction between two groups had no statistical difference (RR=0.74, 95%CI: 0.54~1.01, P=0.06). Conclusion In the treatment of patients with acute ST-segment elevated myocardial infarction and multivessel disease, complete revascularization is safe and effective. It reduced the incidence of MACE, cardiovascular mortality, all-cause mortality and repeat revascularization, which can improve the prognosis of patients.
Keywords：Complete revascularizationCulprit artery interventionAcute ST-segment elevated myocardial infarctionMultivessel diseasePrognosisMeta-analysis
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 24-28 )