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  • Kolte, DhavalBrown Univ, Dept Med, Div Cardiol, Providence, RI 02912 USA. (author)

Culprit Vessel-Only Versus Multivessel Percutaneous Coronary Intervention in Patients With Cardiogenic Shock Complicating ST-Segment-Elevation Myocardial Infarction : A Collaborative Meta-Analysis

  • Article/chapterEnglish2017

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  • LIPPINCOTT WILLIAMS & WILKINS,2017
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:uu-343327
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-343327URI
  • https://doi.org/10.1161/CIRCINTERVENTIONS.117.005582DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background The optimal revascularization strategy in patients with multivessel disease presenting with cardiogenic shock complicating ST-segment-elevation myocardial infarction remains unknown. Methods and Results Databases were searched from 1999 to October 2016. Studies comparing immediate/single-stage multivessel percutaneous coronary intervention (MV-PCI) versus culprit vessel-only PCI (CO-PCI) in patients with multivessel disease, ST-segment-elevation myocardial infarction, and cardiogenic shock were included. Primary end point was short-term (in-hospital or 30 days) mortality. Secondary end points included long-term mortality, cardiovascular death, reinfarction, and repeat revascularization. Safety end points were in-hospital stroke, renal failure, and major bleeding. The meta-analysis included 11 nonrandomized studies and 5850 patients (1157 MV-PCI and 4693 CO-PCI). There was no significant difference in short-term mortality with MV-PCI versus CO-PCI (odds ratio [OR], 1.08; 95% confidence interval [CI], 0.81-1.43; P=0.61). Similarly, there were no significant differences in long-term mortality (OR, 0.84; 95% CI, 0.54-1.30; P=0.43), cardiovascular death (OR, 0.72; 95% CI, 0.42-1.23; P=0.23), reinfarction (OR, 1.65; 95% CI, 0.84-3.26; P=0.15), or repeat revascularization (OR, 1.13; 95% CI, 0.76-1.69; P=0.54) between the 2 groups. There was a nonsignificant trend toward higher in-hospital stroke (OR, 1.64; 95% CI, 0.98-2.72; P=0.06) and renal failure (OR, 1.30; 95% CI, 0.98-1.72; P=0.06), with no difference in major bleeding (OR, 1.47; 95% CI, 0.39-5.63; P=0.57) with MV-PCI when compared with CO-PCI. Conclusions This meta-analysis of nonrandomized studies suggests that in patients with cardiogenic shock complicating ST-segment-elevation myocardial infarction, there may be no significant benefit with single-stage MV-PCI compared with CO-PCI. Given the limitations of observational data, randomized trials are needed to determine the role of MV-PCI in this setting.

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  • Sardar, ParthaUniv Utah, Dept Med, Div Cardiol, Salt Lake City, UT 84112 USA. (author)
  • Khera, SahilNew York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA. (author)
  • Zeymer, UweInst Herzinfarktforsch Ludwigshafen, Dept Cardiol, Ludwigshafen, Germany. (author)
  • Thiele, HolgerUniv Hosp Schleswig Holstein, Univ Heart Ctr Lubeck, Med Clin 2, Dept Cardiol, Kiel, Germany.;German Cardiovasc Res Ctr DZHK, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany. (author)
  • Hochadel, MatthiasInst Herzinfarktforsch Ludwigshafen, Dept Cardiol, Ludwigshafen, Germany. (author)
  • Radovanovic, DraganaUniv Zurich, AMIS Plus Data Ctr, Zurich, Switzerland. (author)
  • Erne, PaulUniv Zurich, AMIS Plus Data Ctr, Zurich, Switzerland. (author)
  • Hambraeus, Kristina,1970-Uppsala universitet,Centrum för klinisk forskning Dalarna,Falun Cent Hosp, Dept Cardiol, Falun, Sweden.(Swepub:uu)kriha420 (author)
  • James, Stefan K,1964-Uppsala universitet,Kardiologi(Swepub:uu)stjam367 (author)
  • Claessen, Bimmer E.Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands. (author)
  • Henriques, Jose P. S.Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands. (author)
  • Mylotte, DarrenNatl Univ Ireland, SAOLTA Healthcare Grp, Galway Univ Hosp, Dept Cardiol, Galway, Ireland. (author)
  • Garot, PhilippeHop Prive Jacques Cartier, Inst Cardiovasc Paris Sud, Ramsay Gen Sante, Dept Cardiol, Massy, France. (author)
  • Aronow, Wilbert S.New York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA. (author)
  • Owan, TheophilusUniv Utah, Dept Med, Div Cardiol, Salt Lake City, UT 84112 USA. (author)
  • Jain, DiwakarNew York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA. (author)
  • Panza, Julio A.New York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA. (author)
  • Frishman, William H.New York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA. (author)
  • Fonarow, Gregg C.Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Cardiol, Los Angeles, CA 90095 USA. (author)
  • Bhatt, Deepak L.Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Dept Med,Div Cardiol, Boston, MA USA. (author)
  • Aronow, Herbert D.Brown Univ, Dept Med, Div Cardiol, Providence, RI 02912 USA. (author)
  • Abbott, J. DawnBrown Univ, Dept Med, Div Cardiol, Providence, RI 02912 USA. (author)
  • Brown Univ, Dept Med, Div Cardiol, Providence, RI 02912 USA.Univ Utah, Dept Med, Div Cardiol, Salt Lake City, UT 84112 USA. (creator_code:org_t)

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  • In:Circulation. Cardiovascular Interventions: LIPPINCOTT WILLIAMS & WILKINS10:111941-76401941-7632

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