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Culprit Vessel-Only...
Culprit Vessel-Only Versus Multivessel Percutaneous Coronary Intervention in Patients With Cardiogenic Shock Complicating ST-Segment-Elevation Myocardial Infarction : A Collaborative Meta-Analysis
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- Kolte, Dhaval (author)
- Brown Univ, Dept Med, Div Cardiol, Providence, RI 02912 USA.
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- Sardar, Partha (author)
- Univ Utah, Dept Med, Div Cardiol, Salt Lake City, UT 84112 USA.
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- Khera, Sahil (author)
- New York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA.
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- Zeymer, Uwe (author)
- Inst Herzinfarktforsch Ludwigshafen, Dept Cardiol, Ludwigshafen, Germany.
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- Thiele, Holger (author)
- Univ 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.
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- Hochadel, Matthias (author)
- Inst Herzinfarktforsch Ludwigshafen, Dept Cardiol, Ludwigshafen, Germany.
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- Radovanovic, Dragana (author)
- Univ Zurich, AMIS Plus Data Ctr, Zurich, Switzerland.
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- Erne, Paul (author)
- Univ Zurich, AMIS Plus Data Ctr, Zurich, Switzerland.
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- Hambraeus, Kristina, 1970- (author)
- Uppsala universitet,Centrum för klinisk forskning Dalarna,Falun Cent Hosp, Dept Cardiol, Falun, Sweden.
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- James, Stefan K, 1964- (author)
- Uppsala universitet,Kardiologi
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- Claessen, Bimmer E. (author)
- Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands.
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- Henriques, Jose P. S. (author)
- Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Amsterdam, Netherlands.
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- Mylotte, Darren (author)
- Natl Univ Ireland, SAOLTA Healthcare Grp, Galway Univ Hosp, Dept Cardiol, Galway, Ireland.
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- Garot, Philippe (author)
- Hop Prive Jacques Cartier, Inst Cardiovasc Paris Sud, Ramsay Gen Sante, Dept Cardiol, Massy, France.
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- Aronow, Wilbert S. (author)
- New York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA.
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- Owan, Theophilus (author)
- Univ Utah, Dept Med, Div Cardiol, Salt Lake City, UT 84112 USA.
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- Jain, Diwakar (author)
- New York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA.
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- Panza, Julio A. (author)
- New York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA.
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- Frishman, William H. (author)
- New York Med Coll, Dept Med, Westchester Med Ctr, Div Cardiol, Valhalla, NY 10595 USA.
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- Fonarow, Gregg C. (author)
- Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Cardiol, Los Angeles, CA 90095 USA.
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- Bhatt, Deepak L. (author)
- Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Dept Med,Div Cardiol, Boston, MA USA.
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- Aronow, Herbert D. (author)
- Brown Univ, Dept Med, Div Cardiol, Providence, RI 02912 USA.
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- Abbott, J. Dawn (author)
- Brown Univ, Dept Med, Div Cardiol, Providence, RI 02912 USA.
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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)
- LIPPINCOTT WILLIAMS & WILKINS, 2017
- 2017
- English.
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In: Circulation. Cardiovascular Interventions. - : LIPPINCOTT WILLIAMS & WILKINS. - 1941-7640 .- 1941-7632. ; 10:11
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- cardiogenic shock
- complete revascularization
- mortality
- myocardial infarction
- percutaneous coronary intervention
- stroke
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Kolte, Dhaval
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Sardar, Partha
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Khera, Sahil
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Zeymer, Uwe
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Thiele, Holger
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Hochadel, Matthi ...
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Radovanovic, Dra ...
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Erne, Paul
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Hambraeus, Krist ...
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James, Stefan K, ...
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Claessen, Bimmer ...
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Henriques, Jose ...
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Mylotte, Darren
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Garot, Philippe
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Aronow, Wilbert ...
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Owan, Theophilus
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Jain, Diwakar
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Panza, Julio A.
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Frishman, Willia ...
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Fonarow, Gregg C ...
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Bhatt, Deepak L.
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Aronow, Herbert ...
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Abbott, J. Dawn
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Circulation. Car ...
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Uppsala University