{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T21:57:31Z","timestamp":1781906251863,"version":"3.54.5"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5,30]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Multivessel disease is common in non-ST elevation myocardial infarction patients. However, whether multivessel percutaneous coronary intervention is superior to culprit vessel percutaneous coronary intervention is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A meta-analysis was conducted including studies that compared multivessel percutaneous coronary intervention (MV-PCI) and culprit vessel percutaneous coronary intervention among non-ST elevation myocardial infarction patients. Relative risk (RR) for mortality, myocardial infarction (MI), repeat revascularization and procedural complications was calculated using a random effects model. Seventeen studies were included in the meta-analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>There was no difference in short-term outcomes for mortality (RR 0.917, 95% CI 0.613\u20131.371, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.672), MI (RR 0.960, 95% CI 0.612\u20131.507, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.861), and stent thrombosis (RR 1.338, 95% CI 0.655\u20132.733, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.424). Long-term mortality and repeat revascularization was significantly lower in the MV-PCI group (RR 0.746, 95% CI 0.644\u20130.865, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005&lt;\u2005.001 and RR 0.775, 95% CI 0.629\u20130.954, <jats:italic toggle=\"yes\">P<\/jats:italic>\u2005=\u2005.016), respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>No significant difference was demonstrated between the 2 strategies in the short-term outcomes. However, long-term outcomes in the MV-PCI group were superior to culprit vessel percutaneous coronary intervention in non-ST elevation myocardial infarction patients with multivessel disease. Long-term outcomes included mortality, repeat revascularization, stent thrombosis, and MI. However, randomized controlled trials are needed to compare the safety and efficacy of these strategies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/md.0000000000042527","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T20:01:34Z","timestamp":1749758494000},"page":"e42527","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Multivessel versus culprit vessel only percutaneous coronary intervention in non-ST elevation myocardial infarction: Systematic review and meta-analysis"],"prefix":"10.1097","volume":"104","author":[{"given":"Harshwardhan","family":"Khandait","sequence":"first","affiliation":[{"name":"Trinitas Regional Medical Center\/RWJ Barnabas Health, Elizabeth, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonali","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"Wright Medical Center, Scranton, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Patel","sequence":"additional","affiliation":[{"name":"Saint Michael\u2019s. Medical Center, Newark, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruhma","family":"Ali","sequence":"additional","affiliation":[{"name":"Saint Michael\u2019s. Medical Center, Newark, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Abruzzo","sequence":"additional","affiliation":[{"name":"St George\u2019s School of Medicine, St. George\u2019s, Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0681-3825","authenticated-orcid":false,"given":"Abhigan Babu","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Abdur Rahim Medical College, Dinajpur, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikash","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Larkin Community Hospital, South Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binit","family":"Aryal","sequence":"additional","affiliation":[{"name":"Interfaith Medical Center, Brooklyn, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murad","family":"Aldaraysah","sequence":"additional","affiliation":[{"name":"Trinitas Regional Medical Center\/RWJ Barnabas Health, Elizabeth, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muniba","family":"Naqi","sequence":"additional","affiliation":[{"name":"Trinitas Regional Medical Center\/RWJ Barnabas Health, Elizabeth, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandu","family":"Meshram","sequence":"additional","affiliation":[{"name":"Washington University in St. Louis, St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venugopal Brijmohan","family":"Bhattad","sequence":"additional","affiliation":[{"name":"University of Missouri-Columbia, Columbia, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250612","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/clc.20858","article-title":"Multi-vessel vs single-vessel revascularization in patients with non-ST-segment elevation acute coronary syndrome and multi-vessel disease in the drug-eluting stent era.","volume":"34","author":"Lee","year":"2011","journal-title":"Clin Cardiol"},{"key":"R2-20250612","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.1056\/NEJMoa0807986","article-title":"Early versus delayed invasive intervention in acute coronary syndromes.","volume":"360","author":"Mehta","year":"2009","journal-title":"N Engl J Med"},{"key":"R3-20250612","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1253\/circj.CJ-20-0369","article-title":"Long-term outcomes of single-vessel percutaneous coronary intervention on culprit vessel vs. multi-vessel percutaneous coronary intervention in non-ST-segment elevation acute coronary syndrome patients with multi-vessel coronary artery disease.","volume":"85","author":"Li","year":"2021","journal-title":"Circ J"},{"key":"R4-20250612","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1016\/j.jacc.2018.07.089","article-title":"Complete versus culprit-only lesion intervention in patients with acute coronary syndromes.","volume":"72","author":"Rathod","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"R5-20250612","doi-asserted-by":"crossref","first-page":"407","DOI":"10.4244\/EIJ-D-16-00350","article-title":"Complete or incomplete coronary revascularisation in patients with myocardial infarction and multi-vessel disease: a propensity score analysis from the \u201creal-life\u201d BleeMACS (bleeding complications in a multicenter registry of patients discharged with diagnosis of acute coronary syndrome) registry.","volume":"13","author":"Quadri","year":"2017","journal-title":"EuroIntervention"},{"key":"R6-20250612","doi-asserted-by":"crossref","first-page":"293","DOI":"10.4244\/EIJY14M08_05","article-title":"Prognostic impact of multi-vessel versus culprit vessel only percutaneous intervention for patients with multi-vessel coronary artery disease presenting with acute coronary syndrome.","volume":"11","author":"Hassanin","year":"2015","journal-title":"EuroIntervention"},{"key":"R7-20250612","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/j.1540-8183.2009.00477.x","article-title":"Culprit-only or multi-vessel percutaneous coronary stenting in patients with non-ST-segment elevation acute coronary syndromes: one-year follow-up.","volume":"22","author":"Zapata","year":"2009","journal-title":"J Interv Cardiol"},{"key":"R8-20250612","doi-asserted-by":"crossref","first-page":"1033475","DOI":"10.3389\/fcvm.2022.1033475","article-title":"Culprit vessel vs. immediate multi-vessel vs. out-of-hospital staged intervention for patients with non-ST-segment elevation myocardial infarction and multi-vessel disease.","volume":"9","author":"Wang","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"R9-20250612","doi-asserted-by":"crossref","first-page":"e016575","DOI":"10.1161\/JAHA.120.016575","article-title":"Optimal revascularization strategy in non-ST-segment-elevation myocardial infarction with multivessel coronary artery disease: culprit-only versus one-stage versus multistage revascularization.","volume":"9","author":"Kim","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"R10-20250612","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.atherosclerosis.2020.04.002","article-title":"Culprit-only versus multivessel or complete versus incomplete revascularization in patients with non-ST-segment elevation myocardial infarction and multivessel disease who underwent successful percutaneous coronary intervention using newer-generation drug-eluting stents.","volume":"301","author":"Kim","year":"2020","journal-title":"Atherosclerosis"},{"key":"R11-20250612","doi-asserted-by":"crossref","first-page":"916","DOI":"10.4244\/EIJV9I8A154","article-title":"Single-vessel or multivessel PCI in patients with multivessel disease presenting with non-ST-elevation acute coronary syndromes.","volume":"9","author":"Onuma","year":"2013","journal-title":"EuroIntervention"},{"key":"R12-20250612","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.ahj.2007.09.007","article-title":"Culprit-only or multi-vessel revascularization in patients with acute coronary syndromes: an American College of Cardiology National Cardiovascular Database Registry report.","volume":"155","author":"Brener","year":"2008","journal-title":"Am Heart J"},{"key":"R13-20250612","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.ijcard.2011.11.024","article-title":"Prima-vista multi-vessel percutaneous coronary intervention in haemodynamically stable patients with acute coronary syndromes: analysis of over 4.400 patients in the EHS-PCI registry.","volume":"166","author":"Bauer","year":"2013","journal-title":"Int J Cardiol"},{"key":"R14-20250612","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ijcard.2010.08.044","article-title":"What is optimal revascularization strategy in patients with multivessel coronary artery disease in non-ST-elevation myocardial infarction? Multivessel or culprit-only revascularization.","volume":"153","author":"Kim","year":"2011","journal-title":"Int J Cardiol"},{"key":"R15-20250612","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.jacc.2006.10.054","article-title":"In unstable angina or non-ST-segment acute coronary syndrome, should patients with multi-vessel coronary artery disease undergo multi-vessel or culprit-only stenting?","volume":"49","author":"Shishehbor","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"R16-20250612","doi-asserted-by":"crossref","first-page":"6144","DOI":"10.3390\/jcm11206144","article-title":"Multivessel versus culprit-only percutaneous coronary intervention in patients with non-ST-elevation acute coronary syndrome.","volume":"11","author":"Pustjens","year":"2022","journal-title":"J Clin Med"},{"key":"R17-20250612","first-page":"e23139","article-title":"Target vessel versus complete revascularization in non-ST elevation myocardial infarction without cardiogenic shock.","volume":"14","author":"Pandit","year":"2022","journal-title":"Cureus"},{"key":"R18-20250612","doi-asserted-by":"crossref","first-page":"e0258525","DOI":"10.1371\/journal.pone.0258525","article-title":"Multivessel versus IRA-only PCI in patients with NSTEMI and severe left ventricular systolic dysfunction. Lazzeri C, editor.","volume":"16","author":"Lee","year":"2021","journal-title":"PLoS One"},{"key":"R19-20250612","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.amjcard.2009.03.052","article-title":"Comparison of long-term mortality after percutaneous coronary intervention in patients treated for acute ST-elevation myocardial infarction versus those with unstable and stable angina pectoris.","volume":"104","author":"Hirsch","year":"2009","journal-title":"Am J Cardiol"},{"key":"R20-20250612","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/S0735-1097(02)02049-1","article-title":"Exaggeration of nonculprit stenosis severity during acute myocardial infarction: implications for immediate multi-vessel revascularization.","volume":"40","author":"Hanratty","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"R21-20250612","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.ahj.2004.03.051","article-title":"Multi-vessel percutaneous coronary intervention in patients with multi-vessel disease and acute myocardial infarction.","volume":"148","author":"Corpus","year":"2004","journal-title":"Am Heart J"},{"key":"R22-20250612","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1093\/eurheartj\/ehm184","article-title":"Impact of multi-vessel disease on reperfusion success and clinical outcomes in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction.","volume":"28","author":"Sorajja","year":"2007","journal-title":"Eur Heart J"},{"key":"R23-20250612","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1056\/NEJM200106213442501","article-title":"Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb\/IIIa inhibitor tirofiban.","volume":"344","author":"Cannon","year":"2001","journal-title":"N Engl J Med"},{"key":"R24-20250612","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.amjcard.2008.05.062","article-title":"Distribution and frequency of thin-capped fibroatheromas and ruptured plaques in the entire culprit coronary artery in patients with acute coronary syndrome as determined by optical coherence tomography.","volume":"102","author":"Tanaka","year":"2008","journal-title":"Am J Cardiol"},{"key":"R25-20250612","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.jacc.2008.05.030","article-title":"Frequency and predictor of coronary thin-cap fibroatheroma in patients with acute myocardial infarction and stable angina pectoris.","volume":"52","author":"Fujii","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"R26-20250612","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1093\/eurheartj\/ehaa575","article-title":"2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.","volume":"42","author":"Collet","year":"2021","journal-title":"Eur Heart J"},{"key":"R27-20250612","doi-asserted-by":"crossref","first-page":"525","DOI":"10.4244\/EIJV11I5A104","article-title":"A comparison of multi-vessel and culprit vessel percutaneous coronary intervention in non-ST-segment elevation acute coronary syndrome patients with multi-vessel disease: a meta-analysis.","volume":"11","author":"Qiao","year":"2015","journal-title":"EuroIntervention"},{"key":"R28-20250612","doi-asserted-by":"crossref","first-page":"e0148756","DOI":"10.1371\/journal.pone.0148756","article-title":"Multi-vessel versus single vessel angioplasty in Non-ST elevation acute coronary syndromes: a systematic review and meta-analysis. Ahrens I, editor.","volume":"11","author":"Mariani","year":"2016","journal-title":"PLoS One"},{"key":"R29-20250612","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1056\/NEJMoa1607991","article-title":"Drug-eluting or bare-metal stents for coronary artery disease.","volume":"375","author":"B\u00f8naa","year":"2016","journal-title":"N Engl J Med"},{"key":"R30-20250612","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.amjcard.2006.11.062","article-title":"Cyphering the complexity of coronary artery disease using the syntax score to predict clinical outcome in patients with three-vessel lumen obstruction undergoing percutaneous coronary intervention.","volume":"99","author":"Valgimigli","year":"2007","journal-title":"Am J Cardiol"},{"key":"R31-20250612","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1016\/j.jacc.2010.07.016","article-title":"Stent thrombosis.","volume":"56","author":"Holmes","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"R32-20250612","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.jacc.2009.03.063","article-title":"Prognostic significance of periprocedural versus spontaneously occurring myocardial infarction after percutaneous coronary intervention in patients with acute coronary syndromes.","volume":"54","author":"Prasad","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"R33-20250612","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1016\/j.amjcard.2005.12.068","article-title":"Impact of congestive heart failure in patients with non-ST-segment elevation acute coronary syndromes.","volume":"97","author":"Roe","year":"2006","journal-title":"Am J Cardiol"},{"key":"R34-20250612","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jchf.2013.02.007","article-title":"Heart failure complicating non-ST-segment elevation acute coronary syndrome.","volume":"1","author":"Bahit","year":"2013","journal-title":"JACC Heart Fail"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000042527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T20:01:40Z","timestamp":1749758500000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000042527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":34,"journal-issue":{"issue":"22","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000042527","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]}}}