Current recommendations for revascularization of non-infarct-related artery in patients presenting with ST-segment elevation myocardial infarction and multivessel disease

被引:2
|
作者
Towashiraporn, Korakoth [1 ]
机构
[1] Mahidol Univ, Fac Med Siriraj Hosp, Her Majesty Cardiac Ctr, Bangkok, Thailand
来源
关键词
ST-segment elevation myocardial infarction; multivessel disease; complete revascularization; percutaneous coronary intervention; infarct-related artery; PERCUTANEOUS CORONARY INTERVENTION; LESION-ONLY REVASCULARIZATION; CARDIOGENIC-SHOCK; SCIENTIFIC STATEMENT; RANDOMIZED-TRIAL; CULPRIT LESION; MANAGEMENT; PLAQUE; STEMI; OUTCOMES;
D O I
10.3389/fcvm.2022.969060
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ST-segment elevation myocardial infarction (STEMI) is a leading cause of morbidity and mortality worldwide. Immediate reperfusion therapy of the infarct-related artery (IRA) is the mainstay of treatment, either via primary percutaneous coronary intervention (PPCI) or thrombolytic therapy when PPCI is not feasible. Several studies have reported the incidence of multivessel disease (MVD) to be about 50% of total STEMI cases. This means that after successful PPCI of the IRA, residual lesion(s) of the non-IRA may persist. Unlike the atherosclerotic plaque of stable coronary artery disease, the residual obstructive lesion of the non-IRA contains a significantly higher prevalence of vulnerable plaques. Since these lesions are a strong predictor of acute coronary syndrome, if left untreated they are a possible cause of future adverse cardiovascular events. Percutaneous coronary intervention (PCI) of the obstructive lesion of the non-IRA to achieve complete revascularization (CR) is therefore preferable. Several major randomized controlled trials (RCTs) and meta-analyses demonstrated the clinical benefits of the CR strategy in the setting of STEMI with MVD, not only for enhancing survival but also for reducing unplanned revascularization. The CR strategy is now supported by recently published clinical practice guidelines. Nevertheless, the benefit of revascularization must be weighed against the risks from additional procedures.
引用
收藏
页数:10
相关论文
共 50 条
  • [21] Infarct characteristics and outcome of patients with transient ST-segment elevation myocardial infarction compared to ST-segment and non-ST-segment elevation myocardial infarction
    Demirkiran, A.
    Hoeven, N.
    Janssens, G.
    Lemkes, J.
    Everaars, H.
    Ven, P.
    Cauteren, Y.
    Leeuwen, M.
    Nap, A.
    Bekkers, S.
    Royen, N.
    Smulders, M.
    Rossum, A.
    Robbers, L.
    Nijveldt, R.
    EUROPEAN HEART JOURNAL, 2020, 41 : 195 - 195
  • [22] Long-term clinical outcomes of infarct-related artery versus multivessel revascularization in acute ST-segment elevation myocardial infarction with multivessel disease: an analysis from KAMIR
    Lee, H. W.
    Hong, T. J.
    Ahn, S. K.
    Yang, M. J.
    Choi, J. H.
    Kim, B. W.
    Lee, H. C.
    Cha, K. S.
    EUROPEAN HEART JOURNAL, 2011, 32 : 869 - 870
  • [23] Interventional Strategies for ST-Segment Elevation Myocardial Infarction and Multivessel Coronary Artery Disease
    Bittl, John A.
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 58 (07) : 712 - 714
  • [24] Nomogram to Predict Outcomes After Staged Revascularization in ST-Segment Elevation Myocardial Infarction and Multivessel Coronary Artery Disease
    Wang, Huaigen
    Ma, Aiqun
    Wang, Tingzhong
    INTERNATIONAL JOURNAL OF GENERAL MEDICINE, 2024, 17 : 1713 - 1722
  • [25] Impact of the Residual SYNTAX Score on Outcomes of Revascularization in Patients with ST-Segment Elevation Myocardial Infarction and Multivessel Disease
    Loutfi, Mohamed
    Ayad, Sherif
    Sobhy, Mohamed
    CLINICAL MEDICINE INSIGHTS-CARDIOLOGY, 2016, 10 : 29 - 35
  • [26] New debate of revascularization strategy of non-infarct-related artery lesions in patients with ST-segment elevation myocardial infarction and cardiogenic shock: decoding the CULPRIT-SHOCK trial, not enough to challenge the current guidelines
    Song Fang
    Wu Qiang
    Chen XiaoPing
    中华医学杂志英文版, 2019, 132 (05) : 613 - 614-615
  • [27] New debate of revascularization strategy of non-infarct-related artery lesions in patients with ST-segment elevation myocardial infarction and cardiogenic shock: decoding the CULPRIT-SHOCK trial, not enough to challenge the current guidelines
    Song, Fang
    Wu, Qiang
    Chen, Xiao-Ping
    CHINESE MEDICAL JOURNAL, 2019, 132 (05) : 613 - 615
  • [28] Long-Term Clinical Outcomes of Infarct-Related Artery versus Multivessel Revascularization in Acute ST-Segment Elevation Myocardial Infarction with Multivessel Disease: An Analysis from Korea Acute Myocardial Infarction Registry
    Lee, Han Cheol
    Choi, Jin Hee
    Kim, Bo Won
    Lee, Hye Won
    Yang, Mi Jin
    An, Sung Gyu
    Oh, Jun-Hyok
    Choi, Junghyun
    Cha, Kwang Soo
    Hong, Taek Jong
    CIRCULATION, 2011, 124 (21)
  • [29] Comparison of Approaches to Revascularization in Patients With Multivessel Coronary Artery Disease Presenting With ST-Segment Elevation Myocardial Infarction: Meta-analyses of Randomized Control Trials
    Bajaj, Navkaranbir S.
    Kalra, Rajat
    Aggarwal, Himanshu
    Ather, Sameer
    Gaba, Saurabh
    Arora, Garima
    McGiffin, David C.
    Ahmed, Mustafa
    Aslibekyan, Stella
    Arora, Pankaj
    JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2015, 4 (12):
  • [30] Complete revascularization for patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease: a meta-analysis of randomized trials
    Bajraktari, Gani
    Jashari, Haki
    Ibrahimi, Pranvera
    Alfonso, Fernando
    Jashari, Fisnik
    Ndrepepa, Gjin
    Elezi, Shpend
    Henein, Michael Y.
    CORONARY ARTERY DISEASE, 2018, 29 (03) : 204 - 215