{"id":"e5a91b8408de","type":"article","url":"https://hartvaat.nl/2020/11/07/complete-revascularisatie-vermindert-cv-dood-bij-stemi-met-multivatenlijden-meta/","title":"Complete revascularisatie vermindert CV-dood bij STEMI met multivatenlijden: meta-analyse","title_en":"Complete revascularization reduces cardiovascular death in patients with ST-segment elevation myocardial infarction and multivessel disease: systematic review and meta-analysis of randomized clinical trials.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["ouderen"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehz896","source_url":"https://doi.org/10.1093/eurheartj/ehz896","authors":["Rita Pavasini","Simone Biscaglia","Emanuele Barbato","Matteo Tebaldi","Dariusz Dudek","Javier Escaned","Gianni Casella","Andrea Santarelli","Vincenzo Guiducci","Enrique Gutierrez-Ibanes","Giuseppe Di Pasquale","Luigi Politi","Andrea Saglietto","Fabrizio D'Ascenzo","Gianluca Campo"],"significance":8,"published":"2020-11-07","source_date":"2020-11-07","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stabiele-angina-pectoris/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"This meta-analysis demonstrated that complete revascularization of nonculprit lesions in patients with STEMI and multivessel disease significantly reduces cardiovascular death, providing the strongest evidence yet for a mortality benefit from the complete revascularization strategy.","created":"2026-07-03T10:28:52Z","updated":"2026-07-03T13:28:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse die aantoont dat complete revascularisatie cardiovasculaire dood vermindert bij STEMI met multivatencoronairlijden.","abstract_original":"AIMS: The aim of this work was to investigate the prognostic impact of revascularization of non-culprit lesions in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease by performing a meta-analysis of available randomized clinical trials (RCTs). METHODS AND RESULTS: Data from six RCTs comparing complete vs. culprit-only revascularization in STEMI patients with multivessel disease were analysed with random effect generic inverse variance method meta-analysis. The endpoints were expressed as hazard ratio (HR) with 95% confidence interval (CI). The primary outcome was cardiovascular death. Main secondary outcomes of interest were all-cause death, myocardial infarction (MI), and repeated coronary revascularization. Overall, 6528 patients were included (3139 complete group, 3389 culprit-only group). After a follow-up ranging between 1 and 3 years (median 2 years), cardiovascular death was significantly reduced in the group receiving complete revascularization (HR 0.62, 95% CI 0.39-0.97, I2 = 29%). The number needed to treat to prevent one cardiovascular death was 70 (95% CI 36-150). The secondary endpoints MI and revascularization were also significantly reduced (HR 0.68, 95% CI 0.55-0.84, I2 = 0% and HR 0.29, 95% CI 0.22-0.38, I2 = 36%, respectively). Needed to treats were 45 (95% CI 37-55) for MI and 8 (95% CI 5-13) for revascularization. All-cause death (HR 0.81, 95% CI 0.56-1.16, I2 = 27%) was not affected by the revascularization strategy. CONCLUSION: In a selected study population of STEMI patients with multivessel disease, a complete revascularization strategy is associated with a reduction in cardiovascular death. This reduction is concomitant with that of MI and the need of repeated revascularization."}