The presence of chronic total occlusion in noninfarct-related arteries Is associated with higher mortality and worse patient outcomes following percutaneous coronary intervention for STEMI: A systematic review, meta-analysis and meta-regression
Document Type
Article
Department
Internal Medicine
Abstract
Reperfusion therapy with percutaneous coronary intervention improves outcomes in patients with ST-elevation myocardial infarction. We conducted a meta-analysis to assess the impact of chronic total occlusion (CTO) in noninfarct-related artery on the outcomes of these patients. Comprehensive searches were performed using PubMed, Google Scholar, and EMBASE. The primary endpoint was the 30-day mortality rate, with secondary endpoints including all-cause mortality, repeat myocardial infarction, and stroke. Forest plots were created for the pooled analysis of the results, with statistical significance set at P < 0.05. A total of 19 studies were included in this meta-analysis, with 23,989 patients (3589 in CTO group and 20,400 in no-CTO group). The presence of CTO was associated with significantly higher odds of 30-day mortality [18.38% vs 5.74%; relative risk (RR), 3.69; 95% confidence intervals (CI), 2.68-5.07; P < 0.00001], all-cause mortality (31.00% vs 13.40%; RR, 2.79; 95% CI, 2.31-3.37; P < 0.00001), cardiovascular-related deaths (12.61% vs 4.1%; RR, 2.61; 95% CI, 1.99-3.44; P < 0.00001), and major adverse cardiovascular events (13.64% vs 9.88%; RR, 2.08; 95% CI, 1.52-2.86; P < 0.00001) than the non-CTO group. No significant differences in repeated myocardial infarction or stroke were observed between the CTO and non-CTO groups. Our findings underscore the need for further research on the benefits and risks of performing staged or simultaneous percutaneous coronary intervention for CTO in the noninfarct-related artery in patients with ST-elevation myocardial infarction.
Publication (Name of Journal)
Cardiology in Review
DOI
10.1097/CRD.0000000000000683
Recommended Citation
Goyal, A.,
Maheshwari, S.,
Shahbaz, H.,
Shah, V.,
Shamim, U.,
Shrestha, A. B.,
Sulaiman, S. A.,
Mhatre, P.,
Sohail, A. H.,
Sheikh, A. B.
(2024). The presence of chronic total occlusion in noninfarct-related arteries Is associated with higher mortality and worse patient outcomes following percutaneous coronary intervention for STEMI: A systematic review, meta-analysis and meta-regression. Cardiology in Review, 30(3).
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_med_intern_med/252
Comments
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