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Coronary angiograph...
Coronary angiography- or fractional flow reserve-guided complete revascularization in multivessel disease STEMI : A Bayesian hierarchical network meta-analysis
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- Archilletti, Federico (författare)
- Queen Mary University,University G.d'Annunzio of Chieti-Pescara
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- Ricci, Fabrizio (författare)
- Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups,University G.d'Annunzio of Chieti-Pescara,Casa di Cura Villa Serena
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- Pelliccia, Francesco (författare)
- Sapienza University of Rome
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- Dangas, George (författare)
- Icahn School of Medicine at Mount Sinai
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Giuliani, Livio (författare)
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- Radico, Francesco (författare)
- University G.d'Annunzio of Chieti-Pescara
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Perfetti, Matteo (författare)
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Rossi, Serena (författare)
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- Gallina, Sabina (författare)
- University G.d'Annunzio of Chieti-Pescara
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Maddestra, Nicola (författare)
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- Khanji, Mohammed Y. (författare)
- Barts Health NHS Trust,Queen Mary University,Newham University Hospital
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- Zimarino, Marco (författare)
- University G.d'Annunzio of Chieti-Pescara
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Queen Mary University University Gd'Annunzio of Chieti-Pescara (creator_code:org_t)
- Elsevier BV, 2023
- 2023
- Engelska 7 s.
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 370, s. 122-128
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Aims: To identify the best strategy to achieve complete revascularization (CR) in patients with ST-elevation myocardial infarction (STEMI) and multi-vessel disease (MVD). Methods and results: We systematically reviewed the literature for randomized controlled trials (RCTs) comparing IRA-only PCI and CR guided by angiography or fractional flow reserve (FFR) in MVD-STEMI. Both frequentist (classical) and Bayesian network meta-analysis were performed, including a comparative hierarchy estimation of the probability to reduce the primary composite endpoint of all-cause death and new myocardial infarction (MI). We identified 11 RCTs, including 8193 STEMI patients. Compared with IRA-only strategy, CR significantly reduced the primary endpoint (OR: 0.73; 95%CI0.55–0.97). We observed non-significant difference between angiography and FFR guidance in reducing the primary endpoint (OR: 0.73, 95% CI 0.35–1.57). The Bayesian probability analysis ranked angio-guided CR as the best intervention yielding lowest risk of all-cause death or new MI (SUCRA92%). Conclusions: In patients with MVD-STEMI, CR is associated with a reduction in all-cause mortality and new MI compared with IRA-only PCI. Angio-guided CR is associated with the lowest risk of all-cause death or new MI, therefore the role of FFR-guidance in this setting is questionable. Condensed abstract: Both frequentist and Bayesian network meta-analysis were performed to compare infarct-related artery (IRA)-only percutaneous coronary intervention (PCI) and complete revascularization (CR) guided by angiography or fractional flow reserve (FFR) in multivessel disease (MVD) and acute ST-elevation myocardial infarction (STEMI). Eleven randomized controlled trials were identified, including 8193 STEMI patients. Compared with IRA-only strategy, CR significantly reduced the incidence of the composite endpoint of all-cause death and new myocardial infarction without significant difference in angio-guided and FFR-guided CR. The Bayesian probability analysis ranked angio-guided CR as the best intervention yielding lowest risk of the composite endpoint and, therefore the role of FFR-guidance in this setting is questionable.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Acute myocardial infarction
- Complete revascularization
- Percutaneous coronary intervention
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- Av författaren/redakt...
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Archilletti, Fed ...
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Ricci, Fabrizio
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Pelliccia, Franc ...
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Dangas, George
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Giuliani, Livio
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Radico, Francesc ...
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visa fler...
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Perfetti, Matteo
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Rossi, Serena
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Gallina, Sabina
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Maddestra, Nicol ...
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Khanji, Mohammed ...
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Zimarino, Marco
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visa färre...
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