A major review of 4,472 heart attack patients with multiple blocked arteries compared two treatment strategies. One group had the full artery-opening procedure done immediately, while the other had it done in stages over time. The study followed patients for about 18 months on average.
The main finding was that doing the full procedure immediately did not lower the chance of major heart problems like death, another heart attack, or needing more procedures. The risk was about the same for both groups. This was true for overall death, heart-related death, and repeat heart attacks.
Safety outcomes were also similar between the two approaches. The risks of stroke, major bleeding, and kidney problems from the procedure were comparable. The review included patients mostly in their mid-60s, and most were male.
The authors note some limitations, like differences between the included studies and the exclusion of patients with certain complex blockages. They suggest that the best timing for the procedure should consider the patient's specific situation, the artery anatomy, and hospital logistics.
In summary, for most heart attack patients with multiple blocked arteries, doing the full procedure immediately does not offer a clear advantage over waiting and doing it in stages.