Abstract 4602: Complete Revascularization in Patients With Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Meta Analysis
Background: Complete revascularization with coronary artery bypass graft surgery (CABG) provides greater benefits than incomplete revascularization, in patients with multivessel coronary artery disease (MVD CAD). However, the benefit of complete versus incomplete revascularization with percutaneous coronary intervention (PCI) is not known.
Methods: PUBMED/EMBASE/CENTRAL search for studies evaluating PCI in patients with multivessel CAD. Studies which compared patients receiving complete revascularization (CR) vs. incomplete revascularization (IR) were included for the analyses. We accepted the definition of complete revascularization in various studies. Long term cardiovascular events were evaluated.
Results: Among 26 studies of 46260 patients with MVD CAD, complete revascularization was achieved in 16168 (35%) patients. Complete revascularization was associated with a 35% lower risk of all cause death (Figure⇓), significantly lower cardiac mortality (OR=0.65, 95% CI 0.46–0.90), non fatal myocardial infarction (OR=0.79, 95% CI 0.70–0.89) and the need for CABG (OR=0.51, 95% CI 0.39–0.65) compared to patients undergoing incomplete revascularization. Complete revascularization was associated with a 31% less angina with no difference in repeat PCI (OR=0.92, 95% CI 0.74–1.13).
Conclusions: In patients with multivessel CAD, complete revascularization by PCI is associated with a lower risk of long term adverse cardiovascular events and greater improvement in angina symptoms.