{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:32:15Z","timestamp":1761863535267},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,11,3]],"date-time":"2015-11-03T00:00:00Z","timestamp":1446508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To perform an updated meta\u2010analysis to determine whether complete revascularization of significant coronary lesions at the time of primary percutaneous coronary intervention (PCI) would be associated with better outcomes compared with culprit\u2010only revascularization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Individual trials have demonstrated conflicting evidence regarding the optimum revascularization strategy at the time of primary PCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical trials that randomized ST elevation myocardial infarction (STEMI) patients with multi\u2010vessel disease to a complete versus culprit\u2010only revascularization strategy were included. Random effects summary risk ratios (RR) were constructed using a DerSimonian\u2013Laird model. The primary outcome of interest was mortality or myocardial infarction (MI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of seven trials with 1,939 patients were included in the analysis. Compared with culprit\u2010only revascularization, complete revascularization was associated with a non\u2010significant reduction in the risk of mortality or MI (RR 0.69, 95% confidence interval (CI) 0.42\u20131.12, <jats:italic>P<\/jats:italic>\u2009=\u20090.14). Complete revascularization was associated with a reduced risk of major adverse cardiac events (MACE) (RR 0.61, 95% CI 0.45\u20130.81, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), due to a significant reduction in urgent revascularization (RR 0.46, 95% CI 0.29\u20130.70, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The risk of major bleeding and contrast\u2010induced nephropathy was similar with both approaches (RR 0.83, 95% CI 0.41\u20131.71, <jats:italic>P<\/jats:italic>\u2009=\u20090.62, and RR 0.94, 95% CI 0.42\u20132.12, <jats:italic>P<\/jats:italic>\u2009=\u20090.82).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Complete revascularization of all significant coronary lesions at the time of primary PCI was associated with a reduction in the risk of MACE due to reduction in the risk of urgent revascularization. This approach appears to be safe, with no excess major bleeding, or contrast\u2010induced nephropathy. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26322","type":"journal-article","created":{"date-parts":[[2015,11,3]],"date-time":"2015-11-03T11:30:42Z","timestamp":1446550242000},"page":"501-505","source":"Crossref","is-referenced-by-count":21,"title":["Complete Versus Culprit\u2010Only Revascularization for Patients With Multi\u2010Vessel Disease Undergoing Primary Percutaneous Coronary Intervention: An Updated Meta\u2010Analysis of Randomized Trials"],"prefix":"10.1002","volume":"88","author":[{"given":"Islam Y.","family":"Elgendy","sequence":"first","affiliation":[{"name":"Department of Medicine University of Florida Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuerong","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Florida Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Florida Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony A.","family":"Bavry","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Florida Gainesville Florida"},{"name":"North Florida\/South Georgia Veterans Health Systems Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,11,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1305520"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.12.038"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.03.163"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.002142"},{"key":"e_1_2_6_6_1","unstructured":"HlinomazO.Multivessel coronary disease diagnosed at the time of primary PCI for STEMI: Complete revascularization versus conservative strategy (PRAGUE 13 trial). 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