Systematic review and meta-analysis comparing complete versus incomplete or culprit-only revascularization by percutaneous coronary intervention in elderly patients with acute coronary syndrome

Complete revascularization (CR) is favored over culprit-only or incomplete revascularization (IR) for patients with acute coronary syndrome (ACS) and multi-vessel disease (MVD) due to better long-term outcomes. However, the optimal revascularization strategy is currently uncertain in elderly patient...

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Bibliographic Details
Published in:Current problems in cardiology 2024-12, Vol.49 (12), p.102790, Article 102790
Main Authors: Goyal, Aman, Tariq, Muhammad Daoud, Singh, Ajeet, Thakkar, Kamya Uday, Brateanu, Andrei, Mahalwar, Gauranga
Format: Article
Language:English
Subjects:
Angioplasty
Cardiology
Complete revascularization
Elderly
Meta-analysis
Percutaneous coronary intervention
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Summary:Complete revascularization (CR) is favored over culprit-only or incomplete revascularization (IR) for patients with acute coronary syndrome (ACS) and multi-vessel disease (MVD) due to better long-term outcomes. However, the optimal revascularization strategy is currently uncertain in elderly patients, where frailty, polypharmacy, multi-morbidity, inherent bleeding risk and presumed cognitive decline can often burden the decision-making process. We searched Medline, PubMed, and Google Scholar from inception to April 2024. The search of databases identified relevant studies that reported the comparative effects of CR and IR in the elderly population undergoing percutaneous coronary intervention (PCI). Data was pooled for individual studies using random-effects models on Comprehensive Meta-Analysis software, with statistical significance set at p < 0.05. The meta-analysis included 14 studies and 62577 patients. CR demonstrated a significant reduction in all-cause mortality [RR: 0.680; 95 % CI: 0.57-0.82; p=
ISSN:0146-2806
1535-6280
1535-6280
DOI:10.1016/j.cpcardiol.2024.102790