Multi- versus single-vessel percutaneous coronary intervention for ST-elevation myocardial infarction with multi-vessel disease.

摘要

Widimsky and Holmes [ 1 ] proposed, in their recent review without a meta-analysis, that single-vessel acute percutaneous coronary intervention (PCI) should be the default strategy to treat only the infarct-related artery (IRA) during the acute phase of ST-segment elevation myocardial infarction (STEM1) with multi-vessel disease (MVD). Although several meta-analyses [2-4] of multi-vessel (or complete) versus culprit-only PCI for patients with STEM! have been recently performed, all of them abstracted unadjusted mortality data from a number of non-randomized studies and combined them with those from a few randomized trials. Unlike for randomized trials, however, it usually is appropriate to analyze adjusted, rather than unadjusted, effect estimates, i.e. analyses that attempt to control for confounding [5].