%0 Journal Article
%T Multivessel versus culprit lesion only percutaneous coronary intervention in cardiogenic shock complicating acute myocardial infarction: A systematic review and meta
%A Alexander Jobs
%A Georg Fuernau
%A Holger Thiele
%A Ingo Eitel
%A Janine P£¿ss
%A Roza Meyer-Saraei
%A Steffen Desch
%A Suzanne de Waha
%A Thomas Stiermaier
%A Uwe Zeymer
%J European Heart Journal: Acute Cardiovascular Care
%@ 2048-8734
%D 2018
%R 10.1177/2048872617719640
%X Early revascularisation of the culprit lesion is the therapeutic cornerstone in cardiogenic shock complicating acute myocardial infarction. The optimal management of additional non-culprit lesions is unclear. This systematic review and meta-analysis aims to summarise current evidence on the comparison of immediate multivessel percutaneous coronary intervention (MV-PCI) or culprit lesion only PCI with possible staged revascularisation (C-PCI) in patients with cardiogenic shock complicating acute myocardial infarction. Medical literature databases were screened to identify analyses comparing MV-PCI with C-PCI in patients with cardiogenic shock complicating acute myocardial infarction and multivessel coronary artery disease. In absence of randomised trials, 10 cohort studies were included in the current meta-analysis. The primary outcome of short-term mortality was assessed at hospital discharge or 30 days after hospital admission. Secondary outcomes were long-term mortality as well as myocardial re-infarction, stroke, acute renal failure, and bleeding at short-term follow-up. Of 6051 patients, 1194 (19.7%) received MV-PCI and 4857 (80.3%) C-PCI. Short-term mortality was 37.5% in patients undergoing MV-PCI compared with 28.8% in C-PCI patients (risk ratio 1.26, 95% confidence interval 1.12¨C1.41, p=0.001). Long-term mortality (p=0.77), myocardial re-infarction (p=0.77), stroke (p=0.12), acute renal failure (p=0.17) and bleeding (p=0.53) did not differ significantly between the two revascularisation groups. Results of this first meta-analysis on the interventional management of patients with cardiogenic shock complicating acute myocardial infarction and multivessel coronary artery disease do not support MV-PCI over C-PCI. However, possible treatment selection bias in the individual studies must be taken into account
%K Multivessel coronary artery disease
%K acute myocardial infarction
%K cardiogenic shock
%K reperfusion
%K percutaneous coronary intervention
%U https://journals.sagepub.com/doi/full/10.1177/2048872617719640