Why the study?
Recent trial data challenged guidelines by showing no difference between complete and culprit-only PCI in STEMI with multivessel disease, prompting an updated meta-analysis.
Does complete revascularization reduce mortality and hard clinical endpoints compared to culprit lesion-only PCI in patients with STEMI and multivessel disease?
Comparison
Complete revascularization vs culprit-lesion-only PCI
Design
Updated meta-analysis of randomized clinical trials
Follow-up
12 months to 4.8 years
Key result
Culprit lesion-only PCI increased the risk of myocardial infarction compared to complete revascularization (OR 1.38; 95% CI 1.05-1.81), without differences in overall mortality (OR 1.15; 95% CI 0.98-1.36).
Authors
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Supports complete revascularization to lower recurrent MI in STEMI with multivessel disease; reinforces trial evidence without mortality impact.
Meta-Analysis (n=9,515)
Does complete revascularization reduce mortality and hard clinical endpoints compared to culprit lesion-only PCI in patients with STEMI and multivessel disease?
Odds Ratio: 1.38 (95% CI 1.05–1.81)
In STEMI patients with multivessel disease, complete revascularization reduces non-fatal MI and ischemia-driven revascularization compared to culprit-only PCI, but does not affect overall mortality.
Rodriguez–Granillo et al. (2024) conducted a meta-analysis in ST elevation myocardial infarction (STEMI) with multivessel disease (n=9,515). Culprit lesion only PCI vs. Complete revascularization was evaluated on Myocardial infarction (OR 1.38, 95% CI 1.05-1.81). Culprit lesion-only PCI increased the risk of myocardial infarction compared to complete revascularization (OR 1.38; 95% CI 1.05-1.81), without differences in overall mortality (OR 1.15; 95% CI 0.98-1.36).