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Staged versus index procedure complete revascularization in ST‐elevation myocardial infarction: A meta‐analysis

Staged versus index procedure complete revascularization in ST‐elevation myocardial infarction: A... INTRODUCTIONMultivessel coronary artery disease (CAD) is seen in almost 50% of patients presenting with ST‐elevation myocardial infarction (STEMI). This is associated with worse prognosis compared to patients presenting with single‐vessel disease. Recent randomized control trials such as Preventive Angioplasty in Acute Myocardial Infarction (PRAMI), Complete versus Lesion only Primary Percutaneous Coronary Intervention (CvLPRIT), and Third Danish Study of Optimal Acute Treatment of Patients with STEMI (DANAMI‐3‐PRIMULTI) along with prior metanalyses have demonstrated that complete revascularization significantly reduced adverse cardiovascular events compared to infarct‐related artery (IRA) percutaneous coronary intervention (PCI) alone. To date, it is unclear whether the non‐IRA PCI should be done during the index procedure or as a staged revascularization procedure. While the American College of Cardiology (ACC)/American Heart Association (AHA) upgraded the recommendation for non‐IRA PCI at the time of index procedure or as staged procedure from III to IIb, giving an equal level of recommendation to both index procedure and staged revascularization, the European Society of Cardiology (ESC) gives a IIa recommendation for staged revascularization of non‐IRA and IIb for index procedure revascularization. A recent metanalysis of observational and randomized controlled studies by Tarantini et al and a British Columbia Cardiac Registry study have both demonstrated http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Staged versus index procedure complete revascularization in ST‐elevation myocardial infarction: A meta‐analysis

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References (34)

Publisher
Wiley
Copyright
© 2017 Wiley Periodicals, Inc.
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/joic.12414
pmid
28849628
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONMultivessel coronary artery disease (CAD) is seen in almost 50% of patients presenting with ST‐elevation myocardial infarction (STEMI). This is associated with worse prognosis compared to patients presenting with single‐vessel disease. Recent randomized control trials such as Preventive Angioplasty in Acute Myocardial Infarction (PRAMI), Complete versus Lesion only Primary Percutaneous Coronary Intervention (CvLPRIT), and Third Danish Study of Optimal Acute Treatment of Patients with STEMI (DANAMI‐3‐PRIMULTI) along with prior metanalyses have demonstrated that complete revascularization significantly reduced adverse cardiovascular events compared to infarct‐related artery (IRA) percutaneous coronary intervention (PCI) alone. To date, it is unclear whether the non‐IRA PCI should be done during the index procedure or as a staged revascularization procedure. While the American College of Cardiology (ACC)/American Heart Association (AHA) upgraded the recommendation for non‐IRA PCI at the time of index procedure or as staged procedure from III to IIb, giving an equal level of recommendation to both index procedure and staged revascularization, the European Society of Cardiology (ESC) gives a IIa recommendation for staged revascularization of non‐IRA and IIb for index procedure revascularization. A recent metanalysis of observational and randomized controlled studies by Tarantini et al and a British Columbia Cardiac Registry study have both demonstrated

Journal

Journal of Interventional CardiologyWiley

Published: Oct 1, 2017

Keywords: ; ; ;

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