Complete versus incomplete revascularization with drug‐eluting stents for multi‐vessel disease in stable, unstable angina or non‐ST‐segment elevation myocardial infarction: A meta‐analysis

Ando, Tomo; Takagi, Hisato; Grines, Cindy L.

doi:10.1111/joic.12390

Cited by 14 publications

(12 citation statements)

References 32 publications

(59 reference statements)

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“…Furthermore, complete revascularization in the presence of multivessel CAD is associated with improved long‐term clinical outcomes in STEMI 21,23 . Whether complete revascularization should be performed in patients with non‐STEMI remains unknown, but maybe supported by observational data 33 . Staging procedures for the treatment of non‐culprit stenoses appears to be safe if performed in a timely fashion 34 …”

Section: Preprocedural Assessment Of Coronary Anatomical Complexity Amentioning

confidence: 99%

SCAI position statement on optimal percutaneous coronary interventional therapy for complex coronary artery disease

Riley

Henry

Mahmud

et al. 2020

Cathet Cardio Intervent

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Section: Preprocedural Assessment Of Coronary Anatomical Complexity Amentioning

confidence: 99%

SCAI position statement on optimal percutaneous coronary interventional therapy for complex coronary artery disease

Riley

Henry

Mahmud

et al. 2020

Cathet Cardio Intervent

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“…Despite the existing differences observed among various observational studies, large meta-analyses [32][33][34][35][36] have suggested a significant benefit of CR over IR, including a relative reduction of approximately 30% in mortality. We, on the other hand, did find a better EFS with a CR strategy but without any difference in mortality outcomes.…”

Section: Discussionmentioning

confidence: 99%

Impact of completeness of revascularisation on long-term outcomes in patients with multivessel disease undergoing PCI

Goel¹,

Sahu²,

Layek³

et al. 2021

AsiaIntervention

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Aims:We aimed to study long-term clinical outcomes in patients with multivessel disease (MVD) undergoing percutaneous coronary intervention (PCI) over the last 10 years with respect to the completeness of revascularisation at a tertiary care hospital.Methods and results: A total of 2,960 consecutive MVD patients taken for PCI between 2008 to 2017 were enrolled in the study with baseline demographic, procedural, and follow-up details retrieved from custom-made departmental software. Of those, 2,598 patients with follow-up details constituted the study cohort. Complete revascularisation (CR) was achieved in 1,854 (71.4%) and incomplete revascularisation (IR) in 744 (28.6%) patients. Propensity matching was performed and 740 matched pairs identified in the two groups. The primary endpoint was survival free of any major adverse cardiovascular events (MACE) with each individual MACE event being a secondary endpoint. IR occurred more often in patients with acute coronary syndrome (64.1% vs 58.3%, p=0.003), complex lesion intervention (40.7% vs 29.6%, p<0.001) and in those with mean stent length ≥38 mm per vessel intervened (21.0% vs 13.5%, p<0.001). Median follow-up was 54 months (interquartile range: 31-84 months). After propensity matching, CR resulted in a better survival free of all adverse events, i.e., 86.4% vs 81.1% (HR 1.52, CI: 1.21-2.02; p<0.01). Individual MACE endpoints were, however, not statistically different between the groups. Conclusions:In MVD patients undergoing PCI, CR results in better survival free of all adverse events including all-cause mortality, non-fatal MI, repeat revascularisation and recurrent angina.

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“…20 Complete revascularization has also been implicated in overall improved outcomes when compared with incomplete revascularization. 21,22 Previously, several studies and clinical trials showed the importance of performing complete revascularization in an ST-segment elevation myocardial infarction (STEMI) cohort. 13,23,24 The CvLPRIT and ACUITY trials showed better outcomes and lower MACE rates when performing complete revascularization as compared with culprit vessel treatment only in acute coronary syndrome.…”

Section: Discussionmentioning

confidence: 99%

Gender difference with the use of percutaneous left ventricular assist device in patients undergoing complex high-risk percutaneous coronary intervention: From pVAD Working Group

Doshi

Singh

Jauhar

et al. 2018

European Heart Journal: Acute Cardiovascular Care

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Complete versus incomplete revascularization with drug‐eluting stents for multi‐vessel disease in stable, unstable angina or non‐ST‐segment elevation myocardial infarction: A meta‐analysis

Abstract: CR with DES conferred favorable outcomes compared to IR in MVD patients with stable, unstable angina or NTEMI. Further research to achieve higher CR in MVD patients may lead to improvement in prognosis in these cohorts.

Cited by 14 publications

References 32 publications

SCAI position statement on optimal percutaneous coronary interventional therapy for complex coronary artery disease

SCAI position statement on optimal percutaneous coronary interventional therapy for complex coronary artery disease

Impact of completeness of revascularisation on long-term outcomes in patients with multivessel disease undergoing PCI

Gender difference with the use of percutaneous left ventricular assist device in patients undergoing complex high-risk percutaneous coronary intervention: From pVAD Working Group

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