Evidence map›Paper›PMID 31010423›Full record

SynthesisBMC cardiovascular disorders2019

Complete versus culprit-only revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease: a meta-analysis of randomized trials.

Haiyan Xu, Xiwen Zhang, Jiangjin Li, Hailang Liu, Xiao Hu, Jing Yang

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC cardiovascular disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Haiyan XuDepartment of Cardiology, The affiliated Huaian No.1 People's Hospital of Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, China.
Xiwen ZhangDepartment of Cardiology, The affiliated Huaian No.1 People's Hospital of Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, China.
Jiangjin LiDepartment of Cardiology, The affiliated Huaian No.1 People's Hospital of Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, China.
Hailang LiuDepartment of Cardiology, The affiliated Huaian No.1 People's Hospital of Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, China.
Xiao HuDepartment of Cardiology, The affiliated Huaian No.1 People's Hospital of Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, China.
Jing YangDepartment of Cardiology, The affiliated Huaian No.1 People's Hospital of Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, China. yangjing_hayy@163.com.ORCID 0000-0002-3289-3048
Huaian First People’s Hospital · CNXuzhou Medical College · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe best strategy for the treatment of the non-infarct artery in patients with ST-elevation myocardial infarction (STEMI) and multivessel disease (MVD) undergoing primary percutaneous coronary intervention (PCI) is not yet defined.

methodsWe searched the literature for randomized controlled trials (RCTs) that compared complete revascularization (CR) with infarct-related coronary artery (IRA) only revascularization in hemodynamically stable patients with STEMI. Random effect risk ratios (RRs) were calculated for clinical outcomes.

resultsNine RCTs with 2989 patients were included. No significant difference in all-cause mortality emerged between CR and IRA-only groups (relative risk [RR] = 0.74; 95% confidence interval [CI]: 0.52 to 1.04; p = 0.08). Compared with IRA-only, CR was associated with significantly lower rates of major adverse cardiac events (MACE) (RR = 0.53; 95% CI: 0.41 to 0.68; p < 0.001), cardiac death (RR = 0.48; 95% CI: 0.29 to 0.79; p = 0.004) and repeat revascularization (RR = 0.38; 95% CI: 0.30 to 0.47; p < 0.001). In subgroups analysis, immediate complete revascularization (ICR) reduced the risk of all-cause mortality (RR = 0.62; 95% CI: 0.39 to 0.97; p = 0.04), whereas staged complete revascularization (SCR) did not show any significant benefit in all-cause mortality (RR = 0.92; 95% CI: 0.46 to 1.86; p = 0.82). Stroke, contrast-induced nephropathy and major bleeding were not different between CR and IRA-only.

conclusionsFor patients with STEMI and multivessel disease undergoing primary PCI, complete revascularization did not decrease the risk of all-cause mortality in current evidence from randomized trials. When feasible, immediate complete revascularization might be considered in patients with STEMI and multivessel disease.

Indexed as

Percutaneous Coronary InterventionAgedCause of DeathCoronary Artery DiseaseFemaleHemodynamicsHumansMaleMiddle AgedRandomized Controlled Trials as TopicRecurrenceRisk AssessmentRisk FactorsST Elevation Myocardial InfarctionTreatment OutcomeComplete revascularizationInfarct-related artery only revascularizationMultivessel diseaseST-elevation myocardial infarction

Identifiers

PMID31010423
PMCPMC6477715
OpenAlexW2940839174

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.