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  • Network Meta-Analysis of Percutaneous Intervention-Based Revascularization Strategies for ST-Elevation Myocardial Infarction and Concomitant Multi-Vessel Disease

    • Posted: 07/24/2019
    • Author:

      Urooj Fatima, Safi U. Khan, Olabisi Akanbi, Saket Girotra and Isaac Opoku-Asare

    • CRM2019

    Highlights

    • Approximately 40%–50% patients with ST-elevation myocardial infarction (STEMI) have multi-vessel disease (MVD) that portends worse prognosis.
    • This network meta-analysis (NMA) compares the effect of different revascularization strategies in stable patients with STEMI and MVD.
    • Instant complete revascularization (CR-I) was associated with 40% reduction in all cause mortality compared to (infarct artery revascularization) IRA.
    • Probability analysis ranked CR-I as the best intervention for decreasing mortality.
    • In sensitivity analysis CR-1 was superior to IRA in reducing mortality.

    Abstract

    Background

    In patients with ST elevation myocardial infarction (STEMI) and concomitant multi-vessel disease (MVD), primary percutaneous coronary intervention (PCI) of the culprit vessel is the preferred reperfusion strategy. However, optimum timing of revascularization for non-culprit artery is unclear. In this Bayesian network meta-analysis (NMA), we compared different PCI-based revascularization strategies in STEMI patients with MVD.

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