title: Multivessel revascularisation versus infarct-related artery only revascularisation during the index primary PCI in STEMI patients with multivessel disease: a meta-analysis.
abstract: BACKGROUND
  There are controversial data regarding infarct-related artery only (IRA-PCI) revascularisation versus multivessel revascularisation (MV-PCI) in ST-elevation myocardial infarction (STEMI) patients with multivessel disease undergoing primary percutaneous coronary intervention (PCI). We performed a meta-analysis comparing outcome in same stage MV-PCI versus IRA-PCI in STEMI patients with multivessel disease.
  
  
  METHODS
  Systematic searches of studies comparing MV-PCI with IRA-PCI in the MEDLINE and the Cochrane Database of systematic reviews were conducted. A meta-analysis was performed of all available studies. Primary outcome was all-cause mortality. Secondary endpoints were re-infarction, revascularisation, bleeding and major adverse cardiac events (MACE).
  
  
  RESULTS
  A total of 15 studies were identified with a total number of 35,975 patients. Mortality rate was significantly higher in the MV-PCI group compared with the IRA-PCI group, odds ratio (OR): 1.64 (1.46-1.85). Both the incidence of re-infarction and re-PCI were significantly lower in the MV-PCI group compared with the IRA-PCI group: OR 0.54 (0.34-0.88) and OR 0.67 (0.48-0.93), respectively. Bleeding complications occurred more often in the MV-PCI group as compared with the IRA-PCI group: OR 1.24 (1.08-1.42). Rates of MACE were comparable between the two groups.
  
  
  CONCLUSIONS
  MV-PCI during the index of primary PCI in STEMI patients is associated with a higher mortality rate, a higher risk of bleeding complications, but lower risk of re-intervention and re-infarction and comparable rates of MACE.
authors.affiliation: Department of Cardiology, Maastricht University Medical Centre, PO Box 5800, 6202 AZ, Maastricht, The Netherlands, saman.rasoul@mumc.nl.
authors.forename: S
authors.initials: S
authors.lastname: Rasoul
authors.forename: V
authors.initials: V
authors.lastname: van Ommen
authors.forename: J
authors.initials: J
authors.lastname: Vainer
authors.forename: M
authors.initials: M
authors.lastname: Ilhan
authors.forename: L
authors.initials: L
authors.lastname: Veenstra
authors.forename: R
authors.initials: R
authors.lastname: Erdem
authors.forename: L A W
authors.initials: LA
authors.lastname: Ruiters
authors.forename: R
authors.initials: R
authors.lastname: Theunissen
authors.forename: J C A
authors.initials: JC
authors.lastname: Hoorntje