Evidence map›Paper›PMID 32913394›Full record

ArticleClinical Medicine Insights. Cardiology2020

An Observational Study Assessing Immediate Complete Versus Delayed Complete Revascularisation in Patients with Multi-Vessel Disease Undergoing Primary Percutaneous Coronary Intervention.

Krishnaraj Sinhji Rathod, Marco Spagnolo, Mark K Elliott, Anne-Marie Beirne, Elliot J Smith, Rajiv Amersey, Charles Knight, Roshan Weerackody, Andreas Baumbach, Anthony Mathur and 1 more

Open access · goldAbstract read
In one paragraph

Article in Clinical Medicine Insights. Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 83% 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

1 citing paper in PubMed, 0 citations in OpenAlex.

  1. Review
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

11 authors at 1 institution in 1 country.

Krishnaraj Sinhji RathodBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Marco SpagnoloBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.ORCID https://orcid.org/0000-0002-5434-607X
Mark K ElliottBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Anne-Marie BeirneBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Elliot J SmithBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Rajiv AmerseyBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Charles KnightBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Roshan WeerackodyBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Andreas BaumbachBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Anthony MathurBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.
Daniel A JonesBarts Interventional Group, Interventional Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, UK.ORCID https://orcid.org/0000-0003-1441-0417
St Bartholomew's Hospital · GB

Funding

Department of Health DRF-2014-07-008
6 · The paper itself

Abstract

backgroundMore than half of the patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) have multi-vessel coronary artery disease. This is associated with worse outcomes compared with single vessel disease. Whilst evidence now exists to support complete revascularisation for bystander disease the optimal timing is still debated. This study aimed to compare clinical outcomes in patients with STEMI and multi-vessel disease who underwent complete revascularisation as inpatients in comparison to patients who had staged PCI as early outpatients. METHODS AND

resultsWe conducted an observational cohort study consisting of 1522 patients who underwent primary PCI with multi-vessel disease from 2012 to 2019. Exclusions included patients with cardiogenic shock and previous CABG. Patients were split into 2 groups depending on whether they had complete revascularisation performed as inpatients or as staged PCI at later outpatient dates. The primary outcome of this study was major adverse cardiac events (consisting of myocardial infarction, target vessel revascularisation and all-cause mortality).834 (54.8%) patients underwent complete inpatient revascularisation and 688 patients (45.2%) had outpatient PCI (median 43 days post discharge). Of the inpatient group, 652 patients (78.2%) underwent complete revascularisation during the index procedure whilst 182 (21.8%) patients underwent inpatient bystander PCI in a second procedure. Overall, there were no significant differences between the groups with regards to their baseline or procedural characteristics. Over the follow-up period there was no significant difference in MACE between the cohorts (

conclusionsOur study demonstrated that the timing of bystander PCI after STEMI did not appear to have an effect on cardiovascular outcomes. We suggest that patients with multi-vessel disease can potentially be discharged promptly and undergo early outpatient bystander PCI. This could significantly reduce length of stay in hospital.

Indexed as

PCIstaged PCI

Identifiers

PMID32913394
PMCPMC7444144
OpenAlexW3080210599

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.