Complete Versus Incomplete Revascularization in Elderly Patients With Myocardial Infarction: A Systematic Review and Meta-Analysis

Coronary artery disease (CAD) is the leading cause of mortality in the United States, and percutaneous coronary intervention (PCI) is established as the standard after an acute episode of CAD. This review assessed the use of complete revascularization (CR) or incomplete revascularization (IR) in older adults, who present a higher cardiovascular risk. The aim is to define the effectiveness of both procedures in this population, focusing on major adverse cardiovascular events (MACE), myocardial infarction (MI), and all-cause mortality (ACM). A literature search identified 15 studies, evaluated using the Risk of Bias 2 (RoB 2) tool and the Risk of Bias in Non-Randomized Studies of Interventions I (ROBINS-I) tool for bias risk. Despite positive results in recent studies, this meta-analysis does not show the superiority of CR, demonstrating a lack of benefit in reducing mortality, myocardial infarction, and adverse events in the ≥ 70-year-old age group.