Abstract:
AIM To systematically evaluate the influence of different revascularization strategies on the prognosis of patients with non-ST-segment elevation myocardial infarction with multi-vessel lesions, so as to provide guidance for clinical diagnosis and treatment.
METHODS The databases of Pubmed, Embase, CNKI and Wanfang were searched by computer, and randomized controlled clinical studies on the treatment of non-ST-segment elevation myocardial infarction with multiple vessel lesions using different revascuation strategies were collected to evaluate the quality of the included studies. After extracting effective data, Meta analysis was conducted using Revman 5.3 software.
RESULTS A total of 32, 671 patients, including 15, 076 patients who underwent PCI only and 17, 595 patients who underwent PCI with multiple vessels, were included in the final 7 articles. Meta analysis results showed that compared with PCI alone, PCI significantly reduced the incidence of major cardiovascular events (OR=0.77, 95%CI0.60, 0.99, P=0.04), cardiogenic mortality (OR=0.74, 95%CI0.61, 0.89, P=0.002), and the rate of revascularization (OR=0.62, 95%CI0.49, 0.79). P < 0.0001) and the incidence of recurrent mi (OR=0.71, 95%CI0.58, 0.87, P=0.0008), and the difference was statistically significant, while there was no significant difference in the incidence of all-cause death between the two groups (OR=0.80, 95%CI0.52, 1.21, P=0.29).
CONCLUSION PCI is safe and effective in patients with non-ST-segment elevation myocardial infarction (NSTEMI) combined with multiple vessel lesions, and significantly reduces the incidence of MACE events, cardiogenic death, revascularization, and recurrent myocardial infarction, and improves prognosis, compared with PCI alone.
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