000			04377nam a22006617a 4500
008			180619s20182018 xxu||||| |||| 00| 0 eng d
022			_a1569-5794
024			_a10.1007/s10554-018-1362-9 [doi]
024			_a10.1007/s10554-018-1362-9 [pii]
040			_aOvid MEDLINE(R)
099			_a29779179
245			_aClinical outcomes of complete revascularization using either angiography-guided or fractional flow reserve-guided drug-eluting stent implantation in non-culprit vessels in ST elevation myocardial infarction patients: insights from a study based on a systematic review and meta-analysis. [Review]
251			_aThe International Journal of Cardiovascular Imaging. 34(9):1349-1364, 2018 Sep.
252			_aInt J Cardiovasc Imaging. 34(9):1349-1364, 2018 Sep.
253			_aThe international journal of cardiovascular imaging
260			_c2018
260			_fFY2019
266			_d2018-06-19
269			_fFY2018
520			_aCurrent guidelines recommend that percutaneous coronary intervention (PCI) should be restricted to the culprit vessel in ST elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) and without cardiogenic shock. However, newer data suggests that performing complete revascularization (CR) in MVD patients may lead to better outcomes compared to intervention in the culprit vessel only. The aim of this meta-analysis is to examine the available data to determine if CR (using either angio- or fractional flow reserve guidance-FFR) following primary PCI in STEMI patients without cardiogenic shock impacts clinical outcomes. Meta-analysis was performed by conducting a literature search of PubMed from January 2004 to July 2017. Pooled estimates of outcomes, presented as odds ratios (OR) [95% confidence intervals], were generated using random-effect models. A total of 9 studies (3317 patients) were included. CR showed a significant MACE reduction (OR 0.49, 95% CI 0.36-0.66, p<0.001); All-cause mortality (OR 0.69, 95% CI 0.48-0.98, p=0.04) and repeat revascularization (OR 0.38, 95% CI 0.28-0.51, p<0.001) at>=12 months follow-up. The FFR-guiding CR group presented a MACE reduction (odds ratio 0.52, 95% CI 0.30-0.90, p=0.02) due to a decrease of repeat revascularization (OR 0.41, 95% CI 0.21-0.80, p=0.009). Overall, performing complete revascularization in STEMI patients showed a MACE reduction, all-cause death and repeat revascularization. Compared to culprit-only revascularization, treating multi-vessel disease in STEMI patients using FFR guidance is associated with decreased incidence of MACE, due to a decreased rate of revascularization.
546			_aEnglish
650			_a*Coronary Artery Disease/th [Therapy]
650			_a*Drug-Eluting Stents
650			_a*Myocardial Revascularization/mt [Methods]
650			_a*Percutaneous Coronary Intervention
650			_a*ST Elevation Myocardial Infarction/th [Therapy]
650			_aCoronary Angiography
650			_aCoronary Artery Disease/co [Complications]
650			_aCoronary Artery Disease/dg [Diagnostic Imaging]
650			_aCoronary Artery Disease/pp [Physiopathology]
650			_aFractional Flow Reserve, Myocardial
650			_aHumans
650			_aST Elevation Myocardial Infarction/dg [Diagnostic Imaging]
650			_aST Elevation Myocardial Infarction/et [Etiology]
650			_aST Elevation Myocardial Infarction/pp [Physiopathology]
650			_aTreatment Outcome
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
657			_aReview
700			_aAzizi, Viana
700			_aBeyene, Solomon
700			_aBrathwaite, Echo J
700			_aDan, Kazuhiro
700			_aDesale, Sameer
700			_aDheendsa, Aaphtaab
700			_aGarcia-Garcia, Hector M
700			_aHideo-Kajita, Alexandre
700			_aKuku, Kayode
700			_aLipinski, Michael
700			_aMeirovich, Yael F
700			_aMelaku, Gebremedhin
700			_aOzaki, Yuichi
700			_aSoud, Mohammad
700			_aWaksman, Ron
790			_aAzizi V, Beyene SS, Brathwaite EJ, Dan K, Desale S, Dheendsa A, Garcia-Garcia HM, Hideo-Kajita A, Kuku KO, Lipinski M, Meirovich YF, Melaku GD, Ozaki Y, Soud M, Waksman R
856			_uhttps://dx.doi.org/10.1007/s10554-018-1362-9 _zhttps://dx.doi.org/10.1007/s10554-018-1362-9
942			_cART _dArticle
999			_c3385 _d3385