| Objective: To evaluate the prognosis value of three different percutaneous coronary interention(PCI)strategy in acute ST segment elevation myocardial infarction(STEMI)patients with multivessel disease.Methods: Literature on the impact of different PCI treatment strategies in the prognosis of MVD patients with STEMI publicated between January 2001 and June 2017 were retrieved by searching PubMed,EMbase,Web of Science and CNKI.Using major adverse cardiovascular events(MACE)incidence,mortality,recurrence rate of myocardial infarction,restent implantation rate as the primary end point events,RevMan 5.2 and Stata 11.0 statistics software were used to compare three kinds of treatment strategies.Results: The total sample size was 49586.The results of meta-analysis showed that with different clinical outcomes as the endpoints of prognosis,the three treatment strategies were different.Short term mortality: culprit PCI vs MV-PCI,OR(95% CI)= 0.84(0.61,1.16),P=0.30;Culprit PCI vs staged PCI,OR(95% CI)= 2.72(2.05,3.62),P <0.0001;MV-PCI vs staged PCI,OR(95% CI)=5.02(2.11,11.96),P = 0.0003.Long term mortality: culprit PCI vs MV-PCI,OR(95% CI)=0.86(0.64,1.15),P =0.30;Culprit PCI vs staged PCI,OR(95% CI)=2.31(1.92,2.79),P< 0.0001;MV-PCI vs staged PCI,OR(95% CI)=2.40(1.48,3.90),P = 0.0003.There was no significant difference in the incidence of myocardial infarction and MACE in the culprit PCIvs.MV-PCI.However,there was a statistical difference in re-stent implantation between the two groups.Conclusion:Different PCI strategies are related to the prognosis of STEMI patients with MVD.Compared with culprit PCI,patients with MV-PCI had a lower incidence of re-stent implantation.Comparing to the other strategies,staged PCI group had lower long-term and short-term mortality. |
