title: Culprit vessel only versus multivessel percutaneous coronary intervention in patients presenting with ST-segment elevation myocardial infarction and multivessel disease.
abstract: BACKGROUND
  The best strategy for ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease (MVD), who underwent primary percutaneous coronary intervention (PCI) in the acute phase, is not well established.
  
  
  OBJECTIVE
  Our goal was to conduct a meta-analysis comparing culprit vessel only percutaneous coronary intervention (culprit PCI) with multivessel percutaneous coronary intervention (MV-PCI) for treatment of patients with STEMI and MVD.
  
  
  METHODS
  Pubmed, Elsevier, Embase, and China National Knowledge Infrastructure (CNKI) databases were systematically searched for randomized and nonrandomized studies comparing culprit PCI and MV-PCI strategies during the index procedure. A meta-analysis was performed using Review Manager 5.1 (Cochrane Center, Denmark).
  
  
  RESULTS
  Four randomized and fourteen nonrandomized studies involving 39,390 patients were included. MV-PCI strategy is associated with an increased short-term mortality (OR: 0.50, 95% CI: 0.32 to 0.77, p = 0.002), long-term mortality (OR: 0.52, 95% CI: 0.36 to 0.74, p<0.001), and risk of renal dysfunction (OR: 0.77, 95% CI: 0.61 to 0.97, p = 0.03) compared with culprit PCI strategy, while it reduced the incidence of revascularization (OR: 2.65, 95% CI: 1.80 to 3.90, p<0.001).
  
  
  CONCLUSIONS
  This meta-analysis supports current guidelines which indicate that the non-culprit vessel should not be treated during the index procedure.
authors.affiliation: Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Xiantao
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Shuzheng
authors.initials: S
authors.lastname: Lv
authors.affiliation: Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Yuan
authors.affiliation: Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Yan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014463:Ultrasonography