Current Cardiology Reports

, Volume 12, Issue 4, pp 330–337 | Cite as

Coronary Intervention in Patients With Acute Coronary Syndrome: Does Every Culprit Lesion Require Revascularization?



In patients presenting with acute coronary syndromes, 30–60% of patients have multiple significant coronary lesions. Patients presenting with acute coronary syndrome and multivessel disease have a significant increase in the incidence of major cardiovascular morbidity and mortality when compared with patients who have single-vessel disease. Although great progress has been made to reduce the extent of infarction through effective and rapid reperfusion due to faster time to reperfusion, potent antiplatelets, and antithrombotics, there is not much consensus as to how best to treat multivessel disease in patients presenting with acute coronary syndromes. We present a review of the current body of evidence for safety and efficacy of multivessel revascularization in patients presenting with acute coronary syndromes.


Culprit lesion angioplasty Acute coronary syndromes Complete revascularization 

Clinical Trial Acronyms


Bypass Angioplasty Revascularization Investigation


Coronary Artery Surgery Study


Fondaparinux Trial With UFH During Revascularization in Acute Coronary Syndromes


Hepacoat for Culprit or Multivessel Stenting for Acute Myocardial Infarction


Providing Regional Observations to Study Predictors of Events in the Coronary Tree


Thrombolysis and Angioplasty in Myocardial Infarction


Treat Angina With Aggrastat and Determine Cost of Therapy With an Invasive or Conservative Strategy



Dr. David P. Faxon is on the advisory board for Johnson & Johnson, and has stock options in RIVA medical. No other potential conflicts of interest relevant to this article were reported.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Cardiology, Department of Medicine, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA

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