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- Academic Editor
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†These authors contributed equally.
§These two authors shared seniorship for the present study.
Background: About half of patients with ST-segment Elevation Myocardial
Infarction (STEMI) have multivessel coronary artery disease (MVD). Our aim was to
provide a quantitative comparison of single-stage complete revascularization
during the index revascularization versus deferred staged complete
revascularization in STEMI patients with MVD. Methods: All studies
evaluating patients with STEMI and MVD were included. The primary endpoint was a
composite of all-cause death, myocardial infarction and repeat revascularization.
Secondary endpoints were cardiovascular death, acute kidney injury and trial
defined major bleeding. Results: Eight studies and 2256 patients with
STEMI and MVD were included. No difference was evident in the rate of the primary
composite endpoint among the study group (Risk Ratio 0.95; 95% CI 0.71–1.27,
p = 0.74), while meta-regression showed a significant interaction with
drug eluting stent (DES) use (Coefficient –0.005; 95% CI –0.01 to –0.001;
p = 0.007). Higher rates of cardiovascular (CV) death were found in the
immediate complete revascularization group (5.0% vs 2.6%; Risk Ratio 0.39; 95%
CI 0.25–0.62; p