{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:10Z","timestamp":1787018110188,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,11,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The comparative outcomes with immediate, staged in\u2010hospital, and staged out\u2010of\u2010hospital complete revascularization for patients with ST\u2010segment\u2013elevation myocardial infarction and multivessel disease remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">An electronic search of MEDLINE, SCOPUS, and Cochrane databases was performed through August 2023 for randomized trials evaluating immediate, staged in\u2010hospital, and staged out\u2010of\u2010hospital complete revascularization for patients with ST\u2010segment\u2013elevation myocardial infarction and multivessel disease. The primary outcome was major adverse cardiac events (MACEs). The final analysis included 9 trials with 4270 patients. The weighted follow\u2010up duration was 13.8\u2009months. On pairwise meta\u2010analysis, there were no statistically significant differences between immediate versus staged nonculprit percutaneous coronary intervention (PCI) in MACEs (odds ratio, 0.79 [95% CI, 0.54\u20131.16]). Network meta\u2010analysis showed that there was no statistically significant difference in MACEs with staged in\u2010hospital nonculprit PCI (odds ratio, 1.29\u2013[95% CI, 0.91\u20131.82]) compared with immediate nonculprit PCI, while there were higher odds of MACEs with out\u2010of\u2010hospital nonculprit PCI (odds ratio, 1.67\u2013[95% CI, 1.21\u20132.30]) compared with immediate nonculprit PCI. Compared with immediate nonculprit PCI, there were higher odds of ischemia\u2010driven repeat revascularization with staged out\u2010of\u2010hospital nonculprit PCI (odds ratio, 2.26\u2013[95% CI, 1.37\u20133.72]), but not with in\u2010hospital staged nonculprit PCI. There were no significant differences for the other outcomes among the 3 strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among patients with ST\u2010segment\u2013elevation myocardial infarction with multivessel disease, an immediate nonculprit PCI approach was associated with similar clinical outcomes to the staged nonculprit PCI approach. The staged out\u2010of\u2010hospital nonculprit PCI approach was associated with a higher incidence of MACEs compared with the other strategies, which was driven by higher risk for ischemia\u2010driven repeat revascularization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.035535","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T07:50:27Z","timestamp":1730188227000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Immediate Versus Staged Complete Revascularization for Patients With ST\u2010Segment\u2013Elevation Myocardial Infarction and Multivessel Disease: A Network Meta\u2010Analysis of Randomized Trials"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4248-781X","authenticated-orcid":false,"given":"Ayman","family":"Elbadawi","sequence":"first","affiliation":[{"name":"Christus Good Shepherd Medical Center","place":["Longview, USA"]},{"name":"Texas A&M School of Medicine","place":["Bryan, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2010-0394","authenticated-orcid":false,"given":"Mohamed","family":"Hamed","sequence":"additional","affiliation":[{"name":"Florida Atlantic University","place":["Boca Raton, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0218-3317","authenticated-orcid":false,"given":"Mohamed","family":"Gad","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine","place":["Houston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6069-3131","authenticated-orcid":false,"given":"Sheref A.","family":"Elseidy","sequence":"additional","affiliation":[{"name":"Ain Shams University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0159-2584","authenticated-orcid":false,"given":"Mohamed","family":"Barghout","sequence":"additional","affiliation":[{"name":"Alpert Medical School of Brown University, Lifespan Cardiovascular Institute","place":["Providence, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8754-358X","authenticated-orcid":false,"given":"Hani","family":"Jneid","sequence":"additional","affiliation":[{"name":"University of Texas Medical Branch","place":["Galveston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-8890","authenticated-orcid":false,"given":"Mamas A.","family":"Mamas","sequence":"additional","affiliation":[{"name":"Keele University","place":["Keele, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7480-2511","authenticated-orcid":false,"given":"Fernando","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Hospital Universitario de La Princesa, IIS\u2010IP, CIBER\u2010CV","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9853-7591","authenticated-orcid":false,"given":"Islam Y.","family":"Elgendy","sequence":"additional","affiliation":[{"name":"University of Kentucky","place":["Lexington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.15095"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1907775"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1701067"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.11.047"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000336"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307823"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00351-3"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy223"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.11.027"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.051"},{"key":"e_1_3_1_16_2","first-page":"699","article-title":"The function of the left ventricle after complete multivessel one\u2010stage percutaneous coronary intervention in patients with acute myocardial infarction","volume":"16","author":"Ochala A","year":"2004","unstructured":"Ochala A, Smolka GA, Wojakowski W, Dudek D, Dziewierz A, Krolikowski Z, Gasior Z, Tendera M. The function of the left ventricle after complete multivessel one\u2010stage percutaneous coronary intervention in patients with acute myocardial infarction. J Invasive Cardiol. 2004;16:699\u2013702.","journal-title":"J Invasive Cardiol"},{"key":"e_1_3_1_17_2","first-page":"57","article-title":"Two preventive multivessel stenting strategy with zotarolimus eluting stents in STelevation myocardial infarction patients: 12\u2010month results of randomized trial","volume":"9","author":"Tarasov R","year":"2017","unstructured":"Tarasov R, Ganyukov V, Barbarash O, Barbarash L. Two preventive multivessel stenting strategy with zotarolimus eluting stents in STelevation myocardial infarction patients: 12\u2010month results of randomized trial. Interv Cardiol. 2017;9:57\u201363.","journal-title":"Interv Cardiol"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2023.01.020"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.12.038"},{"key":"e_1_3_1_20_2","doi-asserted-by":"crossref","unstructured":"Nichita\u2010Brendea MT Popescu MI Popa V Carmen PCD. A clinical trial comparing complete revascularization at the time of primary percutaneous coronary intervention versus during the index hospital admission in patients with multi\u2010vessel coronary artery disease and STEMI uncomplicated by cardiogenic shock. 2021;25:781\u2013788.","DOI":"10.5152\/AnatolJCardiol.2021.71080"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2009.177162"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008768"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.01.254"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.01.002"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.035535","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:04:50Z","timestamp":1784113490000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.035535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,5]]},"references-count":23,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2024,11,5]]}},"alternative-id":["10.1161\/JAHA.124.035535"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.035535","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,5]]},"assertion":[{"value":"2024-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e035535"}}