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Acta Medica Colombiana

Print version ISSN 0120-2448

Abstract

SENIOR, Juan Manuel  and  MOLINA, Fernando David. Culprit vessel revascularization versus complete revascularization in multivessel disease in acute myocardial infarction with ST-segment elevation Meta-analysis of clinical trials. Acta Med Colomb [online]. 2016, vol.41, n.2, pp.116-124. ISSN 0120-2448.

Culprit vessel revascularization versus complete revascularization in multivessel disease in acute myocardial infarction with ST segment elevation: meta-analysis of clinical trials.

Introduction:

it has been recommended to perform only culprit vessel revascularization in patients with acute myocardial infarction with ST-segment elevation.

Objectives:

to evaluate the effect of percutaneous revascularization of only the culprit vessel compared to the complete in patients with acute myocardial infarction with ST-segment elevation of less than 12 hours of evolution to reduce critical outcomes.

Materials and Methods:

a systematic search of the literature databases, abstracts of cardiology congress and manual search of primary studies included in other meta-analyzes of clinical randomized trials of patients with acute myocardial infarction with ST-segment elevation of less than 12 hours of evolution, was performed.

Results:

complete percutaneous revascularization strategy does not increase mortality from any cause RR 0.78 (95% CI 0.44-1.39); nor that of cardiovascular origin RR 0.62 (95% CI 0.27-1.44), and reduces the frequency of reinfarction RR 0.39 (95% CI 0.2-0.76), and the frequency of reoperations RR 0.45 (95% CI 0.31 -0.65) in patients with acute myocardial infarction with ST segment elevation, occurring during the first 12 hours of evolution.

Conclusions:

in patients with acute myocardial infarction with ST segment elevation who consult in the first 12 hours, complete revascularization in multivessel disease is safe and decreases the frequency of events such as reinfarction and need for reoperation. (Acta Med Colomb 2016; 41: 116-124).

Keywords : myocardial infarction; myocardial revascularization; multivessel coronary disease; coronary thrombosis; percutaneous coronary intervention; stents.

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