Imperial College London
Portrait Picture

DrRashaAl-Lamee

Faculty of Medicine, National Heart & Lung Institute

Clinical Reader in Cardiovascular Science
 
 
 
//

Contact

 

r.al-lamee13

 
 
//

Location

 

Block B Hammersmith HospitalHammersmith Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Chacko:2020:10.1161/CIRCOUTCOMES.119.006363,
author = {Chacko, L and P, Howard J and Rajkumar, C and Nowbar, AN and Kane, C and Mahdi, D and Foley, M and Shun-Shin, M and Cole, G and Sen, S and Al-Lamee, R and Francis, DP and Ahmad, Y},
doi = {10.1161/CIRCOUTCOMES.119.006363},
journal = {Circulation: Cardiovascular Quality and Outcomes},
title = {Effects of percutaneous coronary intervention on death and myocardial infarction stratified by stable and unstable coronary artery disease: a meta-analysis of randomized controlled trials},
url = {http://dx.doi.org/10.1161/CIRCOUTCOMES.119.006363},
volume = {13},
year = {2020}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:In patients presenting with ST-segment–elevation myocardial infarction, percutaneous coronary intervention (PCI) reduces mortality when compared with fibrinolysis. In other forms of coronary artery disease (CAD), however, it has been controversial whether PCI reduces mortality. In this meta-analysis, we examine the benefits of PCI in (1) patients post–myocardial infarction (MI) who did not receive immediate revascularization; (2) patients who have undergone primary PCI for ST-segment–elevation myocardial infarction but have residual coronary lesions; (3) patients who have suffered a non–ST-segment–elevation acute coronary syndrome; and (4) patients with truly stable CAD with no recent infarct. This analysis includes data from the recently presented International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) and Complete versus Culprit-Only Revascularization Strategies to Treat Multivessel Disease after Early PCI for STEMI (COMPLETE) trials.Methods and Results:We systematically identified all randomized trials of PCI on a background of medical therapy for the treatment of CAD. The ISCHEMIA trial, presented in November 2019, was eligible for inclusion. Data were combined using a random-effects meta-analysis. The primary end point was all-cause mortality. Forty-six trials, including 37 757 patients, were eligible. In the 3 unstable scenarios, PCI had the following effects on mortality: unrevascularized post-MI relative risk (RR) 0.68 (95% CI, 0.45–1.03); P=0.07; multivessel disease following ST-segment–elevation myocardial infarction (RR, 0.84 [95% CI, 0.69–1.04]; P=0.11); non–ST-segment–elevation acute coronary syndrome (RR, 0.84 [95% CI, 0.72–0.97]; P=0.02). Overall, in these unstable scenarios PCI was associated with a significant reduction in mortality (RR, 0.84 [95% CI, 0.75–0.93]; P=0.02). In unstable CAD, PCI also reduced cardiac
AU  - Chacko,L
AU  - P,Howard J
AU  - Rajkumar,C
AU  - Nowbar,AN
AU  - Kane,C
AU  - Mahdi,D
AU  - Foley,M
AU  - Shun-Shin,M
AU  - Cole,G
AU  - Sen,S
AU  - Al-Lamee,R
AU  - Francis,DP
AU  - Ahmad,Y
DO  - 10.1161/CIRCOUTCOMES.119.006363
PY  - 2020///
SN  - 1941-7705
TI  - Effects of percutaneous coronary intervention on death and myocardial infarction stratified by stable and unstable coronary artery disease: a meta-analysis of randomized controlled trials
T2  - Circulation: Cardiovascular Quality and Outcomes
UR  - http://dx.doi.org/10.1161/CIRCOUTCOMES.119.006363
UR  - http://hdl.handle.net/10044/1/77294
VL  - 13
ER  -
Download