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Complete versus partial revascularization for older adults with acute coronary syndrome: a meta-analysis and systematic review of randomized and multivariable adjusted data.
Carvalho Ferreira, André Luiz; Garcez de Carvalho Feitoza, Luanna Paula; Cáceres Lessa, Ana Yasmin; Chaves de Oliveira, Juliana; Chierici Pereira, Lucas; Benitez Gonzalez, Maria Esther; Coelho Pessoa Lima, Ana Emanuela; Ferreira Neves, Henrique Alexsander; Mota Guida, Camila.
Afiliación
  • Carvalho Ferreira AL; Department of Medicine, Pontifical Catholic University of Parana, Curitiba.
  • Garcez de Carvalho Feitoza LP; Department of Medicine, FAMETRO University Center, Manaus, Brazil.
  • Cáceres Lessa AY; Department of Medicine, Jacobi Medical Center, New York City, New York.
  • Chaves de Oliveira J; Department of Medicine, Detroit Medical Center/Wayne State University, Detroit, Michigan.
  • Chierici Pereira L; Department of Medicine, Jefferson Einstein Hospital, Philadelphia, Pennsylvania.
  • Benitez Gonzalez ME; Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
  • Coelho Pessoa Lima AE; Department of Medicine, Bahiana School of Medicine and Public Health, Salvador.
  • Ferreira Neves HA; Department of Medicine, Federal University of Parana, Curitba.
  • Mota Guida C; Department of Cardiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil.
Coron Artery Dis ; 2024 Jun 04.
Article en En | MEDLINE | ID: mdl-38829316
ABSTRACT

BACKGROUND:

Evidence from randomized studies support complete over culprit-only revascularization for patients with acute coronary artery syndrome (ACS) and multivessel coronary artery diseases (MVD). Whether these findings extend to elderly patients, however, has not been thoroughly explored.

METHODS:

We conducted a systematic review and meta-analysis comparing clinical outcomes of elderly individuals (defined as age ≥75 years) with ACS and MVD submitted to complete vs partial-only percutaneous coronary intervention (PCI). PubMed, Embase, and Cochrane were searched. We computed pooled hazard ratios with 95% confidence intervals (CI) to preserve time time-to-event data.

RESULTS:

We included 7 studies, of which 2 were RCT and 5 were multivariable adjusted cohorts, comprising a total 10 147, of whom 43.8% underwent complete revascularization. As compared with partial-only PCI, complete revascularization was associated with a lower all-cause mortality (hazard ratio 0.71; 95% CI 0.60-0.85; P < 0.01), cardiovascular mortality (hazard ratio 0.64; 95% CI 0.52-0.79; P < 0.01), and recurrent myocardial infarction (hazard ratio 0.65; 95% CI 0.50-0.85; P < 0.01). There was no significant difference between groups regarding the risk of revascularizations (hazard ratio 0.80; 95% CI 0.53-1.20; P = 0.28).

CONCLUSION:

Among elderly patients with ACS and multivessel CAD, complete revascularization is associated with a lower risk of all-cause mortality, cardiovascular mortality, and recurrent myocardial infarction.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Coron Artery Dis Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Coron Artery Dis Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido