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Complete Versus Culprit-Only Revascularization in STEMI: a Contemporary Review

  • Daniel Y. Lu
  • Ming Zhong
  • Dmitriy N. Feldman
Coronary Artery Disease (D Feldman and V Voudris, Section Editors)
  • 107 Downloads
Part of the following topical collections:
  1. Topical Collection on Coronary Artery Disease

Abstract

Purpose of review

In ST-segment elevation myocardial infarction, urgent revascularization of the culprit coronary vessel and restoration of coronary flow is the goal of the initial management. However, obstructive non-culprit disease is frequently concomitantly found during initial angiography and portends a poor prognosis. Management of non-culprit lesions in ST-segment elevation myocardial infarction (STEMI) has been the subject of extensive debate. This review will examine the currently available evidence, with a specific focus on randomized clinical trials performed to date.

Recent findings

Although early observational data suggested better outcomes with culprit-only revascularization, more recent data from several randomized trials have suggested improved outcomes with complete multivessel revascularization, either during the index PCI procedure or as a staged procedure.

Summary

Data from recent randomized controlled trials have suggested the superiority of complete or multivessel revascularization and have subsequently led to changes to the most recent iterations of STEMI guidelines. However, the optimal management and timing of revascularization of non-culprit lesions in STEMI remain controversial.

Keywords

ST-segment elevation Myocardial infarction Coronary artery disease STEMI 

Notes

Compliance with Ethical Standards

Conflict of Interest

Daniel Y. Lu and Ming Zhong each declare no potential conflicts of interest.

Dmitriy N. Feldman is a section editor for Current Treatment Options in Cardiovascular Medicine.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Daniel Y. Lu
    • 1
  • Ming Zhong
    • 1
  • Dmitriy N. Feldman
    • 1
  1. 1.Greenberg Division of Cardiology, Department of MedicineFrom Weill Cornell Medical College, New York Presbyterian HospitalNew YorkUSA

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