Imperial College London

ProfessorDarrelFrancis

Faculty of MedicineNational Heart & Lung Institute

Professor of Cardiology
 
 
 
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Contact

 

+44 (0)20 7594 3381d.francis Website

 
 
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Assistant

 

Miss Juliet Holmes +44 (0)20 7594 5735

 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ahmad:2020:10.1161/JAHA.119.015263,
author = {Ahmad, Y},
doi = {10.1161/JAHA.119.015263},
journal = {Journal of the American Heart Association},
pages = {1--83},
title = {Complete revascularisation by percutaneous coronary intervention for patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease: an updated meta-analysis and meta-regression of randomized trials},
url = {http://dx.doi.org/10.1161/JAHA.119.015263},
volume = {9},
year = {2020}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - BackgroundFor patients with STsegment–elevation myocardial infarction (STEMI) and multivessel coronary artery disease, the optimal treatment of the noninfarctrelated artery has been controversial. This uptodate metaanalysis focusing on individual clinical end points was performed to further evaluate the benefit of complete revascularization with percutaneous coronary intervention for patients with STEMI and multivessel coronary artery disease.Methods and ResultsWe systematically identified all randomized trials comparing complete revascularization with percutaneous coronary intervention to culpritonly revascularization for multivessel disease in STEMI and performed a randomeffects metaanalysis. The primary efficacy end point was cardiovascular death analyzed on an intentiontotreat basis. Secondary end points included allcause mortality, myocardial infarction, and unplanned revascularization. Ten studies (7542 patients) were included: 3664 patients were randomized to complete revascularization and 3878 to culpritonly revascularization. Across all patients, complete revascularization was superior to culpritonly revascularization for reduction in the risk of cardiovascular death (relative risk [RR], 0.68; 95% CI, 0.47–0.98; P=0.037; I2=21.8%) and reduction in the risk of myocardial infarction (RR, 0.65; 95% CI, 0.54–0.79; P<0.0001; I2=0.0%). Complete revascularization also significantly reduced the risk of unplanned revascularization (RR, 0.37; 95% CI, 0.28–0.51; P<0.0001; I2=64.7%). The difference in allcause mortality with percutaneous coronary intervention was not statistically significant (RR, 0.85; 95% CI, 0.69–1.04; P=0.108; I2=0.0%).ConclusionsFor patients with STEMI and multivessel disease, complete revascularization with percutaneous coronary intervention significantly improves hard clinical outcomes including cardiovascular death and myocardial infarction. These data have implications for clinical practice gu
AU - Ahmad,Y
DO - 10.1161/JAHA.119.015263
EP - 83
PY - 2020///
SN - 2047-9980
SP - 1
TI - Complete revascularisation by percutaneous coronary intervention for patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease: an updated meta-analysis and meta-regression of randomized trials
T2 - Journal of the American Heart Association
UR - http://dx.doi.org/10.1161/JAHA.119.015263
UR - https://www.ahajournals.org/doi/10.1161/JAHA.119.015263
UR - http://hdl.handle.net/10044/1/80043
VL - 9
ER -