Complete versus culprit-only revascularization for older adults with acute coronary syndromes: a meta-analysis and systematic review
Ferreira, André Luiz Carvalho; Lessa, Ana Yasmin Caceres; Pereira, Lucas Chierici; Oliveira, Juliana Chaves de; Lima, Ana Emanuela; Gonzalez, Maria E. Benitez; Neves, Henrique Alexsander; Guida, Camila Mota.
J. Am. Coll. Cardiol
; 83(13 Suppl. A)Apr. 2024. tab.
Artículo
en Inglés
| CONASS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1551808
BACKGROUND:
Randomized studies support complete over culprit-only revascularization for patients with acute coronary syndrome (ACS) However,whether these findings extend to elderly patients 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 multivessel coronary artery disease submitted to complete vs. culprit-only percutaneous coronary intervention (PCI). PubMed, Embase, and Cochrane were searched. We computed pooled hazard ratios (HRs) with 95% confidence intervals (CI) to preserve time-to-event dataRESULTS:
We included 7 studies, of which 2 were randomized controlled trials (RCTs), comprising 7,409 patients, of whom 3225 (43.5%) underwent complete revascularization. As compared with culprit lesion only PCI, complete revascularization was associated with a lower risk of all-cause mortality (HR 0.76; 95% CI 0.68-0.85; p<0.001), cardiovascular mortality (HR 0.67; 95% CI 0.54-0.82; p<0.001), and recurrent myocardial infarction (MI) (HR 0.65; 95% CI 0.50-0.85; p=0.002). There was no significant difference between the groups regarding the risk of recurrent revascularizations (HR 0.79; 95% CI 0.54-1.16; p=0.23).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 MI.
Biblioteca responsable:
BR79.1
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