1. Effects of patient characteristics on the efficacy of complete revascularization for treatment of ST-segment elevation myocardial infarction with multivessel disease
- Author
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Lu-Feng Li, Shu-Yan Liu, Hai-Rong Zhou, and Mei Qiu
- Subjects
Male ,medicine.medical_specialty ,Funnel plot ,medicine.medical_treatment ,culprit-only revascularization ,MACE ,Coronary Artery Disease ,Revascularization ,Severity of Illness Index ,multivessel disease ,law.invention ,STEMI ,03 medical and health sciences ,Electrocardiography ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Postoperative Complications ,Sex Factors ,Randomized controlled trial ,law ,Internal medicine ,Myocardial Revascularization ,Medicine ,Humans ,030212 general & internal medicine ,Myocardial infarction ,cardiovascular diseases ,Randomized Controlled Trials as Topic ,business.industry ,Hazard ratio ,complete revascularization ,Age Factors ,General Medicine ,Publication bias ,medicine.disease ,Confidence interval ,Treatment Outcome ,Heart Disease Risk Factors ,030220 oncology & carcinogenesis ,Cardiology ,ST Elevation Myocardial Infarction ,Female ,business ,Mace ,Systematic Review and Meta-Analysis ,Research Article - Abstract
Background: Several randomized controlled trials (RCTs) have evaluated the efficacy of complete vs culprit-only revascularization for treatment of ST-segment elevation myocardial infarction (STEMI) with multivessel disease. However, the efficacy of complete revascularization vs culprit-only revascularization in some STEMI patient subgroups remains unclear. Methods: We searched PubMed and Embase for related RCTs from the start date of databases to January 3, 2020. The endpoint assessed in this meta-analysis was major adverse cardiac events (MACE). Random-effects meta-analysis was conducted stratified by each of the 5 factors of interest (i.e., sex, age, history of diabetes, ECG infarct location, and the number of arteries with stenosis) to estimate pooled hazard ratio and 95% confidence interval. Random-effects meta-regression was conducted to assess subgroup differences. We examined publication bias by drawing funnel plots and performing Egger test. This meta-analysis is reported according to the PRISMA statement. Results: Six RCTs were included for pooled analysis. Compared with culprit-only revascularization, complete revascularization significantly reduced the risk of MACE (hazard ratio 0.48, 95% confidence interval 0.42–0.55; I2 = 0%; P for relative effect
- Published
- 2021