Evidence mapPaperPMID 40100813Full record

SynthesisPloS one2025

A riddle of culprit only vs multivessel or immediate vs staged revascularization in patients with non-ST elevation acute coronary syndrome: A meta-analysis.

Yudi Her Oktaviono, Jannatin Nisa Arnindita, Pandit Bagus Tri Saputra, Nabilah Azzah Putri Wairooy, Arlia Ayu Damayanti, Suryo Ardi Hutomo, Nando Reza Pratama, Makhyan Jibril Al Farabi, Faisal Yusuf Ashari

Abstract readMeta-Analysis
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Yudi Her OktavionoDepartment of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.ORCID https://orcid.org/0000-0002-2350-2789
Jannatin Nisa ArninditaDepartment of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.ORCID https://orcid.org/0000-0002-3103-6239
Pandit Bagus Tri SaputraDepartment of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.ORCID https://orcid.org/0000-0002-5815-0592
Nabilah Azzah Putri WairooyFaculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.ORCID https://orcid.org/0000-0003-2916-6859
Arlia Ayu DamayantiFaculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.ORCID https://orcid.org/0000-0001-9864-6624
Suryo Ardi HutomoDepartment of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.ORCID https://orcid.org/0000-0002-0592-3117
Nando Reza PratamaNuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0001-5627-7525
Makhyan Jibril Al FarabiDepartment of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.ORCID https://orcid.org/0000-0002-8182-2676
Faisal Yusuf AshariDepartment of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.ORCID https://orcid.org/0009-0007-0426-5291

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPercutaneous coronary intervention (PCI) is a revolutionary breakthrough in saving many lives from myocardial infarction. However, little is known about the PCI strategy in multivessel disease (MVD) Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) patients. Should complete revascularization be achieved or culprit-only is sufficient, then when the appropriate time of multivessel revascularization is, whether it is staged or immediate. Limited evidence is available on this matter compared to ST-elevation myocardial infarction (STEMI), even though NSTE-ACS patients carry poorer long-term prognoses compared to STEMI.

methodsA thorough search for appropriate studies was executed across PubMed, Embase, Medline, Science Direct, and Scopus databases until July 4th, 2023. The risk ratio (RR) underwent analysis through Review Manager 5.4.

resultsTwenty-six studies with 222,350 MVD NSTE-ACS patients were included. Culprit-only revascularization was significantly related to a higher risk of non-fatal MI (RR: 1.41, 95% CI: 1.04-1.91, p = 0.03, I2: 65%) and all-repeat revascularization (RR 1.86, 95% CI 1.07-3.25, p = 0.03). While multistage multivessel revascularization was related to significantly higher all-cause mortality (RR: 1.73; 95% CI 1.43-2.10; p < 0.01; I2: 0%), TVR repeat (RR 1.38 95% CI 1.11-1.73, I2 =  18%, p = 0.004), and non-TVR repeat (RR 2.59; 95% CI 1,56-4.30; p = 0.0002; I2: 70%).

conclusionPatients with MVD NSTE-ACS treated with multivessel revascularization showed more favorable results than culprit-only. One-stage multivessel revascularization resulted in fewer adverse events than multistage. Additionally, a comprehensive and methodical prospective investigation is required to validate the factors accountable for these outcomes.

Indexed as

Acute Coronary SyndromeMyocardial RevascularizationNon-ST Elevated Myocardial InfarctionPercutaneous Coronary InterventionHumansTreatment Outcome

Identifiers

PMID40100813
PMCPMC11918328

What Socratic holds

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Registered trials

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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.