Clinical outcomes of complete revascularization using either angiography-guided or fractional flow reserve-guided drug-eluting stent implantation in non-culprit vessels in ST elevation myocardial infarction patients: insights from a study based on a systematic review and meta-analysis

The International Journal of Cardiovascular Imaging
Alexandre Hideo-KajitaMichael Lipinski

Abstract

Current guidelines recommend that percutaneous coronary intervention (PCI) should be restricted to the culprit vessel in ST elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) and without cardiogenic shock. However, newer data suggests that performing complete revascularization (CR) in MVD patients may lead to better outcomes compared to intervention in the culprit vessel only. The aim of this meta-analysis is to examine the available data to determine if CR (using either angio- or fractional flow reserve guidance-FFR) following primary PCI in STEMI patients without cardiogenic shock impacts clinical outcomes. Meta-analysis was performed by conducting a literature search of PubMed from January 2004 to July 2017. Pooled estimates of outcomes, presented as odds ratios (OR) [95% confidence intervals], were generated using random-effect models. A total of 9 studies (3317 patients) were included. CR showed a significant MACE reduction (OR 0.49, 95% CI 0.36-0.66, p < 0.001); All-cause mortality (OR 0.69, 95% CI 0.48-0.98, p = 0.04) and repeat revascularization (OR 0.38, 95% CI 0.28-0.51, p < 0.001) at ≥ 12 months follow-up. The FFR-guiding CR group presented a MACE reduction (odds ratio 0.52, 95% CI 0.30-...Continue Reading

References

Apr 1, 1976·Circulation·L M ZirJ W Harthorne
Oct 1, 1991·Journal of the American College of Cardiology·R M FlemingK L Gould
Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Nov 5, 1999·The New England Journal of Medicine·F ZijlstraH Suryapranata
Jan 22, 2005·International Journal of Epidemiology·Giuseppe G L Biondi-ZoccaiFrancesco Burzotta
Jan 16, 2009·The New England Journal of Medicine·Pim A L ToninoUNKNOWN FAME Study Investigators
Jul 28, 2009·Journal of Clinical Epidemiology·David MoherUNKNOWN PRISMA Group
Jul 26, 2011·BMJ : British Medical Journal·Jonathan A C SterneJulian P T Higgins
May 25, 2012·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·A GhaniJ C A Hoorntje
Aug 29, 2012·The New England Journal of Medicine·Bernard De BruyneUNKNOWN FAME 2 Trial Investigators
Sep 3, 2013·The New England Journal of Medicine·David S WaldUNKNOWN PRAMI Investigators
Jan 28, 2015·Revista Española De Cardiología· StephanWindeckerAdam Witkowski
Oct 17, 2016·JACC. Cardiovascular Imaging·Sara GaurBjarne L Nørgaard
Mar 21, 2017·The New England Journal of Medicine·Pieter C SmitsUNKNOWN Compare-Acute Investigators
Mar 21, 2017·The New England Journal of Medicine·Matthias GötbergUNKNOWN iFR-SWEDEHEART Investigators
Mar 21, 2017·The New England Journal of Medicine·Justin E DaviesJavier Escaned
Apr 12, 2017·Journal of the American Heart Association·Rouan GaffarMark J Eisenberg
Jun 11, 2017·Interventional Cardiology Clinics·Sandeep K KrishnanWilliam L Lombardi
Oct 31, 2017·The New England Journal of Medicine·Holger ThieleUNKNOWN CULPRIT-SHOCK Investigators

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Citations

Mar 27, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Martin Sejr-HansenMichael Maeng
Jul 26, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Lukasz KoltowskiJanusz Kochman
Apr 16, 2020·The New England Journal of Medicine·Max Deschner, Anthony Glanz
Mar 15, 2019·The International Journal of Cardiovascular Imaging·Johan H C ReiberNico R L Van de Veire
May 16, 2019·Angiology·Thomas F WhayneAhmed Abdel-Latif
Apr 16, 2020·The New England Journal of Medicine·Shamir R MehtaJohn A Cairns

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