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Article: Percutaneous Coronary Revascularization Strategies After Myocardial Infarction: A Systematic Review and Network Meta-Analysis
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In a systematic review and network meta-analysis on revascularization strategies post-myocardial infarction in patients with multivessel coronary artery disease, it was found that complete revascularization is more beneficial than culprit revascularization. Complete revascularization reduced all-cause mortality, cardiovascular mortality, MI, major adverse cardiac events, and repeat revascularizations. Immediate complete revascularization showed superior outcomes compared to staged procedures. For ST-segment elevation myocardial infarction patients, complete revascularization reduced cardiovascular mortality and MI. The study suggests that immediate complete revascularization may offer advantages based on the hierarchy of revascularization strategies. Safety endpoints did not significantly differ across revascularization approaches. Overall, complete revascularization was shown to reduce mortality, cardiovascular events, and repeat revascularizations post-MI. Immediate complete revascularization may provide better outcomes, but more trials are needed for confirmation. The study evaluated various revascularization strategies, included data from 24 trials and 16,371 patients, and recommended further trials to validate the findings and guide clinical decisions for patients with MI and multivessel CAD.
Keywords
revascularization strategies
post-myocardial infarction
multivessel coronary artery disease
complete revascularization
culprit revascularization
all-cause mortality
cardiovascular events
ST-segment elevation myocardial infarction
immediate complete revascularization
clinical decisions
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