{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:11:57Z","timestamp":1791879117959,"version":"4.3.4"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The ideal timing for complete revascularization (CR) in patients with ST-segment\u2013elevation myocardial infarction and multivessel disease is uncertain. This meta-analysis examined outcomes of immediate CR (ICR) versus staged CR (SCR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Four databases were searched for randomized controlled trials that compared ICR and SCR in ST-segment\u2013elevation myocardial infarction and multivessel disease. The primary end points of interest were short-term and long-term all-cause mortality. Outcomes are presented as risk ratios for short-term outcomes and incidence rate ratios for long-term outcomes with 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The analysis included 9 randomized controlled trials in which 4213 patients were enrolled. Short-term all-cause mortality occurred in 2.0% of patients after ICR compared with 1.2% of patients after SCR (risk ratio, 1.66 [95% CI, 0.99\u20132.78],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.053;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0%). Short-term cardiac death was increased after ICR (risk ratio, 2.19 [95% CI, 1.08\u20134.44],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.03;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0%). At a median 1-year follow-up, all-cause mortality occurred in 4.7% of patients after ICR compared with 3.5% of patients after SCR (incidence rate ratio, 1.40 [95% CI, 0.97\u20132.03],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.07;\n                      <jats:italic toggle=\"yes\">I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0%). No significant differences were identified between the ICR and SCR strategies at either short-term or long-term follow-up for other outcomes, including myocardial infarction, repeat revascularization, stent thrombosis, stroke, major bleeding, and the composite of major adverse cardiac or cerebrovascular events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In hemodynamically stable patients with ST-segment\u2013elevation myocardial infarction and multivessel disease, an ICR strategy may increase short-term cardiac death compared with SCR, and the possibility of increased early and late all-cause mortality cannot be excluded. Despite some uncertainty, these results currently favor a staged CR strategy for most patients with ST-segment\u2013elevation myocardial infarction and multivessel disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/PROSPERO\/\">https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      ; Unique identifier: CRD420251163719.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.126.016601","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T09:00:35Z","timestamp":1777539635000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Timing of Complete Revascularization in Patients With STEMI and Multivessel Disease: An Updated Meta-Analysis of Randomized Clinical Trials"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3083-857X","authenticated-orcid":true,"given":"Mohammed A.","family":"Elbahloul","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Kafr El-Shaikh University, Egypt (M.A.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6776-883X","authenticated-orcid":true,"given":"Shrouk","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ain Shams University, Cairo, Egypt (S.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8051-7512","authenticated-orcid":true,"given":"Eman E.","family":"Labeeb","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Azhar University, Cairo, Egypt (E.E.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2209-2719","authenticated-orcid":true,"given":"Shahed","family":"Aldalahmeh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Jordan University of Science and Technology, Al Ramtha, Jordan (S.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5019-2114","authenticated-orcid":true,"given":"Ahella Ismail A.","family":"Mousa","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Badr University in Cairo (BUC), Egypt (A.I.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1979-3706","authenticated-orcid":true,"given":"Ahmed","family":"Elazab","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, South Valley University, Qena, Egypt (A. Elazab)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9605-1539","authenticated-orcid":true,"given":"Ahmed N.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (A.N.M.), Charleston Area Medical Center (CAMC), WV."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Elashery","sequence":"additional","affiliation":[{"name":"Cardiology Department (A. Elashery), Charleston Area Medical Center (CAMC), WV."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0066-9997","authenticated-orcid":true,"given":"Mehiar O.","family":"El-Hamdani","sequence":"additional","affiliation":[{"name":"Joan C Edwards School of Medicine \u2013 Marshall University, Huntington, WV (M.O.E.-H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-1911","authenticated-orcid":true,"given":"Carl J.","family":"Lavie","sequence":"additional","affiliation":[{"name":"Ochsner Clinical School, John Ochsner Heart and Vascular Institute, The University of Queensland School of Medicine, New Orleans, LA (C.J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3416-8210","authenticated-orcid":true,"given":"Gregg W.","family":"Stone","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, New York, NY 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