JACC. Cardiovascular interventions
Immediate Versus Staged Complete Revascularization in Multivessel Disease and STEMI: A Meta-Analysis of Randomized Trials
Door O'Callaghan D, Rai H, Giacoppo D en 9 anderen.
Inhoud in het Engels
Abstract
Background
For patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization is recommended. The timing of nonculprit lesion intervention, either immediately during the index procedure or staged at a later time, has been investigated in randomized controlled trials (RCTs).
Objectives
This study sought to perform a meta-analysis of RCTs comparing immediate vs staged complete revascularization in patients with multivessel disease presenting with STEMI.
Methods
We conducted a frequentist, pairwise meta-analysis. Studies were selected based on the following inclusion criteria: multicenter RCTs comparing immediate vs staged nonculprit revascularization in patients presenting with STEMI; exclusive use of second-generation (or newer) drug-eluting stents; a follow-up duration of ≥1 year; and publication in a peer-reviewed journal. The primary outcome of interest was all-cause mortality, whereas secondary outcomes included myocardial infarction (MI), cardiac death, and unplanned revascularization. Summary estimates were computed using random-effects models with inverse-variance weighting based on trial-level HRs and 95% CIs. The study protocol was registered on PROSPERO (CRD420251124207).