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Complete versus culprit-only revascularisation for ST-segment elevation myocardial infarction
  1. Eliano Navarese1,
  2. Mariusz Kowalewski2
  1. 1Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
  2. 2Department of Cardiac Surgery, Dr Antoni Jurasz Memorial University Hospital, Bydgoszcz, Poland
  1. Correspondence to Professor Eliano Navarese, Klinik für Kardiologie, Pneumologie und Angiologie, Heinrich-Heine-Universität Düsseldorf, Moorenst 5, Düsseldorf 40225, Germany; eliano.navarese{at}

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The Authors' reply: We read with interest the letter by Dr Shah1 regarding our recent meta-analysis: ‘Complete revascularisation in ST-elevation myocardial infarction and multivessel disease: meta-analysis of randomised controlled trials’.2 The meta-analysis was designed to compare complete multivessel percutaneous coronary intervention (MV-PCI) with non-complete MV-PCI in ST-elevation myocardial infarction (STEMI) and MV disease. Complete MV-PCI was defined as revascularisation to non-infarct-related artery lesions during index procedure, non-complete MV-PCI-encompassed culprit-only revascularisation and staged approaches. First of all, we appreciate the comments by Shah and are glad that our research has become of interest to a large international readership. At the same time, we believe that criticism about methodology or clinical meaningfulness of a meta-analysis should be based on specific clinical knowledge of the topic, and, above all, careful reading of the meta-analysis design.

Shah suggests that because the majority of staged procedures were performed within days to weeks of their index procedures, they would be considered more like complete revascularisation (CR) than incomplete CR over a 12-month follow-up. This is a simply arbitrary reclassification, given the large time discrepancy between the two approaches in …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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