title: Deferred Versus Immediate Stenting in Patients With ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  A number of studies have evaluated the efficacy of deferred stenting vs immediate stenting in patients with ST-segment elevation myocardial infarction, but the findings were not consistent across these studies. This meta-analysis aims to assess optimal treatment strategies in patient with ST-segment elevation myocardial infarction.
  
  
  RESULTS
  We searched the PubMed, EMBASE, and the Cochrane Library for studies that assessed deferred vs immediate stenting in patients with ST-segment elevation myocardial infarction. Nine studies including 1456 patients in randomized controlled trials and 719 patients in observational studies were included in the meta-analysis. No significant differences were observed in the incidence of no- or slow-reflow between deferred stenting and immediate stenting in randomized controlled trials (odds ratio [OR] 0.51, 95%CI 0.17-1.53,P=0.23, I2=70%) but not in observational studies (OR 0.13, 95%CI 0.06-0.31,P<0.0001, I2=0%). Deferred stenting was associated with an increase in long-term left ventricular ejection fraction (weighted mean difference 1.90%, 95%CI 0.77-3.03,P=0.001, I2=0%). No significant differences were observed in the rates of major adverse cardiovascular events (OR 0.53, 95%CI 0.27-1.01,P=0.06 [randomized OR 0.98, 95%CI 0.73-1.30,P=0.87, I2=0%; nonrandomized OR 0.30, 95%CI 0.15-0.58,P=0.0004, I2=0%]), major bleeding (OR=0.1.61, 95%CI 0.70-3.69,P=0.26, I2=0%), death (OR=0.78, 95%CI 0.53-1.15,P=0.22, I2=0%), MI (OR=0.97, 95%CI 0.34-2.78,P=0.96, I2=35%) and target vessel revascularization (OR 0.97, 95%CI 0.40-2.37,P=0.95, I2=24%), between deferred and immediate stenting.
  
  
  CONCLUSIONS
  Compared with immediate stenting, a deferred-stenting strategy did not reduce the occurrence of no- or slow-reflow, death, myocardial infarction, or repeat revascularization compared with immediate stenting in patients with ST-segment elevation myocardial infarction, but showed an improved left ventricular function in the long term.
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Qiao
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Lingxin
authors.initials: L
authors.lastname: Pan
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Yongyan
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Ru
authors.initials: R
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Huiling
authors.initials: H
authors.lastname: Du
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China.
authors.forename: Conghai
authors.initials: C
authors.lastname: Jin
authors.affiliation: Department of Cardiology, Tongling People's Hospital, Tongling, Anhui, China xiongenlai989@126.com.
authors.forename: Enlai
authors.initials: E
authors.lastname: Xiong
mesh_terms: D017130:Angioplasty / Q000379:methods*; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D000072657:ST Elevation Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D015607:Stents; D013318:Stroke Volume; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: ST‐segment elevation myocardial infarction; deferred stenting; immediate stenting; meta‐analysis