Key result
Complete revascularization outperforms culprit-only strategy in STEMI with multivessel disease without cardiogenic shock.
Why the study?
Optimal revascularization strategies and timings for patients with STEMI and multivessel disease remain unclear, with many conclusions drawn from observational studies and conflicting guideline recommendations.
Does complete revascularization improve clinical outcomes compared to culprit-only revascularization in patients with STEMI and multivessel disease?
Does complete revascularization improve clinical outcomes compared to culprit-only revascularization in patients with STEMI and multivessel disease?
This review highlights that complete revascularization is superior to culprit-only revascularization in STEMI patients with multivessel disease without cardiogenic shock, whereas culprit-only revascularization is preferred in the presence of cardiogenic shock.
May support complete revascularization in non-shock STEMI with multivessel disease; leaves open optimal strategy in cardiogenic shock.
Percutaneous coronary intervention is the main strategy of revascularization and has been shown to improve outcomes in some patients with ST-segment elevation myocardial infarction (STEMI). However, multivessel disease (MVD), a common condition in these patients, is associated with worse clinical outcomes compared to single-vessel disease. Despite intervention being a standard treatment for coronary artery disease, optimal strategies and timings for patients with STEMI and MVD remain unclear. Numerous studies and meta-analyses have investigated this topic; however, many current conclusions are based on observational studies. Furthermore, clinical guidelines regarding the management of patients with STEMI and MVD contain conflicting recommendations. Therefore, we aimed to compile relevant studies and newly available evidence-based medicines to explore the most effective approach.
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Zhong et al. (2024) conducted a review in ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD). Complete revascularization vs. Culprit-only revascularization (COR) was evaluated. Complete revascularization is superior to culprit-only revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease without cardiogenic shock.
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