Evidence map›Paper›PMID 40065749›Full record

SynthesisClinical cardiology2025

Clinical Outcomes of Immediate Versus Staged Revascularization of Nonculprit Arteries in Patients With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis.

Farah Yasmin, Syeda Farwa Zaidi, Abdul Moeed, Maryam Shahzad, Muhammad Sohaib Asghar, Mahnoor Sadiq, Javed Iqbal, Salim Surani, M Chadi Alraies

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Clinical cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Farah YasminYale School of Medicine, New Haven, Connecticut, USA.ORCID http://orcid.org/0000-0002-5264-6140
Syeda Farwa ZaidiDow Medical College, Karachi, Pakistan.
Abdul MoeedDow Medical College, Karachi, Pakistan.
Maryam ShahzadDow Medical College, Karachi, Pakistan.
Muhammad Sohaib AsgharAdventHealth, Sebring, Florida, USA.ORCID http://orcid.org/0000-0001-6705-2030
Mahnoor SadiqDow Medical College, Karachi, Pakistan.
Javed IqbalNursing Department, Hamad Medical Corporation, Doha, Qatar.ORCID http://orcid.org/0000-0003-2627-685X
Salim SuraniTexas A&M University, College Station, Texas, USA.
M Chadi AlraiesDetroit Medical Center, Cardiovascular Institute, DMC Heart Hospital, Detroit, Michigan, USA.ORCID http://orcid.org/0000-0002-7874-4566

Funding

This study was supported by Qatar National Library.
6 · The paper itself

Abstract

backgroundRecent guidelines for acute coronary syndrome (ACS) with multivessel coronary artery disease (MVD) recommend revascularization of non-culprit lesions following primary percutaneous coronary intervention (PCI). However, the optimal timing for this procedure-whether immediate or staged-remains uncertain.

methodsA comprehensive search using PubMed (MEDLINE), Cochrane Central, and Google Scholar was conducted to identify studies comparing clinical outcomes between immediate and staged revascularization approaches in patients with MVD undergoing PCI. A random effects model was used to calculate risk ratios (RRs) for dichotomous outcomes with 95% confidence intervals (CIs). The primary outcome was 1-year all-cause mortality.

resultsA total of 10 randomized controlled trials (RCTs), comprising 3886 patients (1964 in the immediate revascularization group and 1940 in the staged revascularization group), with a median follow-up of 12 months, were included in the analysis. No significant difference in the risk of 1-year mortality was noted between the two approaches. The risk of target vessel revascularization (TVR) at 1-year follow-up was significantly lower in the immediate revascularization group compared to the staged revascularization group (RR: 0.64; 95% CI: 0.47-0.86; I²: 0%; p = 0.03). Additionally, the immediate revascularization group had a significantly lower risk of myocardial infarction (MI) at 1-year follow-up than the staged approach (RR: 0.57; 95% CI: 0.37-0.88; I²: 10%; p = 0.01).

conclusionThis meta-analysis suggests that immediate revascularization is associated with a significantly lower risk of TVR and MI at 1-year compared to staged revascularization.

Indexed as

Acute Coronary SyndromePercutaneous Coronary InterventionTime-to-TreatmentHumansRandomized Controlled Trials as TopicRisk FactorsTime FactorsTreatment Outcomeimmediate revascularizationmultivessel diseasepercutaneous coronary interventionstaged revascularization

Identifiers

PMID40065749
PMCPMC11894271

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.