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Precisely Tuned Inhibition of HIF Prolyl Hydroxylases Is Key for Cardioprotection After Ischemia Restenosis, Stent Thrombosis, and Bleeding Complications - Navigating Between Scylla and Charybdis Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction BMI, Infarct Size, and Clinical Outcomes Following Primary PCI Patient-Level Analysis From 6 Randomized Trials Effect of alirocumab on major adverse cardiovascular events according to renal function in patients with a recent acute coronary syndrome: prespecified analysis from the ODYSSEY OUTCOMES randomized clinical trial Chronic total occlusion intervention of the non-infarct-related artery in acute myocardial infarction patients: the Korean multicenter chronic total occlusion registry Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association Anticoagulation combined with antiplatelet therapy in patients with left ventricular thrombus after first acute myocardial infarction Long-term outcomes after myocardial infarction in middle-aged and older patients with congenital heart disease-a nationwide study Acute Noncardiac Organ Failure in Acute Myocardial Infarction With Cardiogenic Shock
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Review Article 2018 Apr 7;20(5):41.

JOURNAL：Curr Treat Options Cardiovasc Med. Article Link

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

Lu DY, Zhong M, Feldman DN. Keywords: Coronary artery disease; Myocardial infarction; ST-segment elevation; STEMI

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. 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.
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