Impact of Immediate Versus Staged Complete Revascularization on Short‐Term and Long‐Term Clinical Outcomes in Patients With Acute Coronary Syndrome and Multivessel Disease: A Systematic Review and Meta‐Analysis

ABSTRACT Background In patients with acute coronary syndrome (ACS) and multivessel disease (MVD), complete revascularization (CR) improves prognosis. This meta‐analysis, summarizing recent RCTs, contrasts short‐term and long‐term clinical outcomes between immediate complete revascularization (ICR) a...

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Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2024-09, Vol.47 (9), p.e70011-n/a
Main Authors: Jia, Qiufeng, Zuo, Ankai, Zhang, Chengrui, Yang, Danning, Zhang, Yu, Li, Jing, An, Fengshuang
Format: Article
Language:English
Subjects:
acute coronary syndrome
Acute Coronary Syndrome - mortality
Acute Coronary Syndrome - surgery
Acute Coronary Syndrome - therapy
Acute coronary syndromes
Angioplasty
Bias
Cardiovascular disease
Clinical outcomes
complete revascularization
Coronary vessels
Data collection
Heart attacks
Humans
immediate
Intervention
Ischemia
Meta-analysis
Mortality
multivessel
Myocardial Revascularization - methods
Percutaneous Coronary Intervention - methods
Review
Risk Factors
staged
Systematic review
Thrombosis
Time Factors
Treatment Outcome
Vein & artery diseases
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Summary:ABSTRACT Background In patients with acute coronary syndrome (ACS) and multivessel disease (MVD), complete revascularization (CR) improves prognosis. This meta‐analysis, summarizing recent RCTs, contrasts short‐term and long‐term clinical outcomes between immediate complete revascularization (ICR) and staged complete revascularization (SCR). Methods We systematically searched the online database and eight RCTs were involved. The primary outcomes included long‐term unplanned ischemia‐driven revascularization, re‐infarction, combined cardiovascular (CV) death or myocardial infarction (MI), all‐cause death, CV death, stroke, and hospitalization for heart failure (HHF). The secondary outcomes were 1‐month unplanned ischemia‐driven revascularization, re‐infarction, all‐cause death, and CV death. Safety endpoints included stent thrombosis and major bleeding. Results Eight RCTs comprising 5198 patients were involved. ICR reduced long‐term unplanned ischemia‐driven revascularization (RR 0.64, 95% CI 0.51–0.81, p 
ISSN:0160-9289
1932-8737
1932-8737
DOI:10.1002/clc.70011