Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment–Elevation Myocardial Infarction: An Individual Patient Meta-Analysis
Authors' conclusion
In this individual patient data meta-analysis of older patients with ST-segment-elevation myocardial infarction and multivessel disease, complete revascularization reduced the primary end point of death, myocardial infarction, or ischemia-driven revascularization up to 4 years. At the longest follow-up, complete revascularization reduced the composite of cardiovascular death or myocardial infarction but not the primary end point.
Study context
- Population
- Patients ≥75 years with STEMI and multivessel disease
- Participants
- 1,733 patients7 RCTs
- Comparison
- Complete vs culprit-only revascularization
- Complete revascularizationn = 816
- Culprit-onlyn = 917reference
- Outcome
- Death, MI or ischemia-driven revascularization
Pooled result
As reported in the abstract
Complete revascularization vs Culprit-onlyHazard ratio (95% CI)
Up to 4 years
0.78(0.63–0.96)
Longest available follow-up
0.83(0.69–1.01)
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| CV death or MI · longest available follow-upAlso observed when censoring follow-up at each year | 0.76 (0.58–0.99) | |
| 0.512Hazard ratio (log scale) |
Death · long-term
- Long-term rate of death did not differ between complete and culprit-only revascularization
Original publication
Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment–Elevation Myocardial Infarction: An Individual Patient Meta-Analysis. Circulation. Published 1 September 2024. doi:10.
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