Key result
Complete revascularization in multivessel STEMI improves outcomes by reducing reinfarction and urgent revascularization.
Why the study?
Although complete revascularization improves clinical outcomes in STEMI with multivessel disease, the optimal timing and modality of non-culprit lesion revascularization remain debated.
This review summarizes the current evidence regarding the timing and modality of revascularizing non-culprit lesions in STEMI patients with multivessel disease.
Answers are grounded in this paper and cite their sources.
May support complete revascularization in multivessel STEMI; leaves open optimal timing and modality for prospective trials.
Multivessel disease is observed in approximately 50% of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Data from randomized clinical trials has shown that complete revascularization in the STEMI setting improves clinical outcomes by reducing the risk of reinfarction and urgent revascularization. However, the timing and modality of revascularization of non-culprit lesions are still debated. PCI of non-culprit lesions can be performed during the index primary PCI or as a staged procedure and can be guided by angiography, functional assessment, or intracoronary imaging. In this review, we summarize the available evidence about the management of non-culprit lesions in STEMI patients with or without cardiogenic shock.
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Piccolo et al. (2023) conducted a review in ST-segment elevation myocardial infarction (STEMI) with multivessel disease. Complete revascularization of non-culprit lesions was evaluated. Complete revascularization of non-culprit lesions in STEMI patients with multivessel disease (present in ~50% of cases) improves clinical outcomes by reducing reinfarction and urgent revascularization.
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