# Complete revascularisatie vermindert CV-dood bij STEMI met multivatenlijden: meta-analyse

*geplaatst 2020-11-07 · Algemeen · European heart journal · doi 10.1093/eurheartj/ehz896 · https://hartvaat.nl/2020/11/07/complete-revascularisatie-vermindert-cv-dood-bij-stemi-met-multivatenlijden-meta/*

Meta-analyse die aantoont dat complete revascularisatie cardiovasculaire dood vermindert bij STEMI met multivatencoronairlijden.

## English: 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.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehz896. Bijgewerkt 2026-07-03T13:28:01Z. 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.