Complete Versus Culprit-Only Revascularization in Older
Patients With ST-Segment-Elevation Myocardial Infarction: An
Individual Patient Meta-Analysis

J 2024

Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis

CAMPO, Gianluca; Felix BOHM; Thomas ENGSTROM; Pieter C SMITS; Islam Y ELGENDY et al.

Základní údaje

Originální název

Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis

Autoři

Vydání

Circulation, Philadelphia, Lippincott Williams Wilkins, 2024, 0009-7322

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 38.600

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/24:00138592

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

complete revascularization; meta-analysis; multivessel disease; myocardial infarction; older patients

Štítky

14110211, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 23. 1. 2025 10:46, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND:Complete revascularization is the standard treatment for patients with ST-segment-elevation myocardial infarction and multivessel disease. The FIRE trial (Functional Assessment in Elderly Myocardial Infarction Patients With Multivessel Disease) confirmed the benefit of complete revascularization in a population of older patients, but the follow-up is limited to 1 year. Therefore, the long-term benefit (>1 year) of this strategy in older patients is debated. To address this, an individual patient data meta-analysis was conducted in patients with ST-segment-elevation myocardial infarction >= 75 years of age enrolled in randomized clinical trials investigating complete versus culprit-only revascularization strategies. METHODS:PubMed, Embase, and the Cochrane database were systematically searched to identify randomized clinical trials comparing complete versus culprit-only revascularization. Individual patient-level data were collected from the relevant trials. The primary end point was death, myocardial infarction, or ischemia-driven revascularization. The secondary end point was cardiovascular death or myocardial infarction. RESULTS:Data from 7 randomized clinical trials encompassing 1733 patients (917 randomized to culprit-only and 816 to complete revascularization) were analyzed. The median age was 79 [interquartile range, 77-83] years. Of the patients, 595 (34%) were female. Follow-up ranged from a minimum of 6 months to a maximum of 6.2 years (median, 2.5 [interquartile range, 1-3.8] years). Complete revascularization reduced the primary end point up to 4 years (hazard ratio, 0.78 [95% CI, 0.63-0.96]) but not at the longest available follow-up (hazard ratio, 0.83 [95% CI, 0.69-1.01]). Complete revascularization significantly reduced the occurrence of cardiovascular death or myocardial infarction at the longest available follow-up (hazard ratio, 0.76 [95% CI, 0.58-0.99]). This was observed even when censoring the follow-up at each year. Long-term rate of death did not differ between complete and culprit-only revascularization arms. CONCLUSIONS:In this individual patient data meta-analysis of older patients with ST-segment-elevation myocardial infarction and multivessel disease, complete revascularization reduced the primary end point of death, myocardial infarction, or ischemia-driven revascularization up to 4 years. At the longest follow-up, complete revascularization reduced the composite of cardiovascular death or myocardial infarction but not the primary end point. REGISTRATION:URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42022367898.

Citovat

CAMPO, Gianluca; Felix BOHM; Thomas ENGSTROM; Pieter C SMITS; Islam Y ELGENDY; Gerry P MCCANN; David A WOOD; Matteo SERENELLI; Stefan JAMES; Dan Eik HOFSTEN; Klerk Bianca M BOXM-DE; Adrian BANNING; John A CAIRNS; Rita PAVASINI; Goran STANKOVIC; Petr KALA; Henning KELBAEK; Emanuele BARBATO; Ilija SRDANOVIC; Mohamed HAMZA; Amerjeet S BANNING; Simone BISCAGLIA a Shamir MEHTA. Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis. Circulation. Philadelphia: Lippincott Williams Wilkins, 2024, roč. 150, č. 19, s. 1508-1516. ISSN 0009-7322. Dostupné z: https://doi.org/10.1161/CIRCULATIONAHA.124.071493.

@article{2470304,
   author = {Campo, Gianluca and Bohm, Felix and Engstrom, Thomas and Smits, Pieter C and Elgendy, Islam Y and McCann, Gerry P and Wood, David A and Serenelli, Matteo and James, Stefan and Hofsten, Dan Eik and Boxmandde, Klerk Bianca M and Banning, Adrian and Cairns, John A and Pavasini, Rita and Stankovic, Goran and Kala, Petr and Kelbaek, Henning and Barbato, Emanuele and Srdanovic, Ilija and Hamza, Mohamed and Banning, Amerjeet S and Biscaglia, Simone and Mehta, Shamir},
   article_location = {Philadelphia},
   article_number = {19},
   doi = {https://doi.org/10.1161/CIRCULATIONAHA.124.071493},
   keywords = {complete revascularization; meta-analysis; multivessel disease; myocardial infarction; older patients},
   language = {eng},
   issn = {0009-7322},
   journal = {Circulation},
   title = {Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis},
   url = {https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.071493},
   volume = {150},
   year = {2024}
}

TY  - JOUR
ID  - 2470304
AU  - Campo, Gianluca - Bohm, Felix - Engstrom, Thomas - Smits, Pieter C - Elgendy, Islam Y - McCann, Gerry P - Wood, David A - Serenelli, Matteo - James, Stefan - Hofsten, Dan Eik - Boxm-de, Klerk Bianca M - Banning, Adrian - Cairns, John A - Pavasini, Rita - Stankovic, Goran - Kala, Petr - Kelbaek, Henning - Barbato, Emanuele - Srdanovic, Ilija - Hamza, Mohamed - Banning, Amerjeet S - Biscaglia, Simone - Mehta, Shamir
PY  - 2024
TI  - Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis
JF  - Circulation
VL  - 150
IS  - 19
SP  - 1508-1516
EP  - 1508-1516
PB  - Lippincott Williams Wilkins
SN  - 00097322
KW  - complete revascularization
KW  - meta-analysis
KW  - multivessel disease
KW  - myocardial infarction
KW  - older patients
UR  - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.071493
N2  - BACKGROUND:Complete revascularization is the standard treatment for patients with ST-segment-elevation myocardial infarction and multivessel disease. The FIRE trial (Functional Assessment in Elderly Myocardial Infarction Patients With Multivessel Disease) confirmed the benefit of complete revascularization in a population of older patients, but the follow-up is limited to 1 year. Therefore, the long-term benefit (>1 year) of this strategy in older patients is debated. To address this, an individual patient data meta-analysis was conducted in patients with ST-segment-elevation myocardial infarction >= 75 years of age enrolled in randomized clinical trials investigating complete versus culprit-only revascularization strategies. METHODS:PubMed, Embase, and the Cochrane database were systematically searched to identify randomized clinical trials comparing complete versus culprit-only revascularization. Individual patient-level data were collected from the relevant trials. The primary end point was death, myocardial infarction, or ischemia-driven revascularization. The secondary end point was cardiovascular death or myocardial infarction. RESULTS:Data from 7 randomized clinical trials encompassing 1733 patients (917 randomized to culprit-only and 816 to complete revascularization) were analyzed. The median age was 79 [interquartile range, 77-83] years. Of the patients, 595 (34%) were female. Follow-up ranged from a minimum of 6 months to a maximum of 6.2 years (median, 2.5 [interquartile range, 1-3.8] years). Complete revascularization reduced the primary end point up to 4 years (hazard ratio, 0.78 [95% CI, 0.63-0.96]) but not at the longest available follow-up (hazard ratio, 0.83 [95% CI, 0.69-1.01]). Complete revascularization significantly reduced the occurrence of cardiovascular death or myocardial infarction at the longest available follow-up (hazard ratio, 0.76 [95% CI, 0.58-0.99]). This was observed even when censoring the follow-up at each year. Long-term rate of death did not differ between complete and culprit-only revascularization arms. CONCLUSIONS:In this individual patient data meta-analysis of older patients with ST-segment-elevation myocardial infarction and multivessel disease, complete revascularization reduced the primary end point of death, myocardial infarction, or ischemia-driven revascularization up to 4 years. At the longest follow-up, complete revascularization reduced the composite of cardiovascular death or myocardial infarction but not the primary end point. REGISTRATION:URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42022367898.
ER  -

CAMPO, Gianluca; Felix BOHM; Thomas ENGSTROM; Pieter C SMITS; Islam Y ELGENDY; Gerry P MCCANN; David A WOOD; Matteo SERENELLI; Stefan JAMES; Dan Eik HOFSTEN; Klerk Bianca M BOXM-DE; Adrian BANNING; John A CAIRNS; Rita PAVASINI; Goran STANKOVIC; Petr KALA; Henning KELBAEK; Emanuele BARBATO; Ilija SRDANOVIC; Mohamed HAMZA; Amerjeet S BANNING; Simone BISCAGLIA a Shamir MEHTA. Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis. \textit{Circulation}. Philadelphia: Lippincott Williams Wilkins, 2024, roč.~150, č.~19, s.~1508-1516. ISSN~0009-7322. Dostupné z: https://doi.org/10.1161/CIRCULATIONAHA.124.071493.

Přehled o publikaci