Coronary disease & ACSMeta-analysis
Percutaneous Coronary Revascularization Strategies After Myocardial Infarction
- Systematic review and network meta-analysis of randomised trials
- frequentist and Bayesian network meta-analyses
Authors' conclusion
Complete revascularization following MI reduces all-cause mortality, cardiovascular mortality, MI, major adverse cardiac events, and repeat revascularization.
Study context
- Population
- Patients with myocardial infarction (MI) and multivessel CAD
- Participants
- 16,371 patients · 24 RCTs
- Comparison
- Complete vs culprit-only revascularization
- Outcome
- All-cause mortality
Pooled result
All-cause mortality (any MI) · weighted mean follow-up 26.4 months
Relative risk
0.85
95% CI 0.74–0.99
P = 0.04
Complete revascularization vs Culprit revascularization
RR 0.85 (95% CI 0.74–0.99); P = 0.04
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality, STEMI (subgroup) | 0.91 (0.78–1.05) | P = 0.18 | |
| 0.512Relative risk (log scale) |
CV mortality, MI, MACE, repeat revascularization
- Also significantly reduced with complete revascularization
Timing of complete revascularization
- Immediate ranked higher than staged complete revascularization for all endpoints
Safety
Stent thrombosis, major bleeding, AKI
- Rates similar
Original publication
Percutaneous Coronary Revascularization Strategies After Myocardial Infarction. J Am Coll Cardiol. Published 16 July 2024. doi:10.1016/j.jacc.2024.04.051
Summarised from the published abstract; every number is checked against it