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Cardiovascular Risk and Statin Eligibility of Young Adults After an MI: Partners YOUNG-MI Registry Prevalence and Prognosis of Unrecognized Myocardial Infarction Determined by Cardiac Magnetic Resonance in Older Adults Age-specific gender differences in early mortality following ST-segment elevation myocardial infarction in China 1-Year Outcomes of Patients Undergoing Primary Angioplasty for Myocardial Infarction Treated With Prasugrel Versus Ticagrelor Complete Revascularization During Primary Percutaneous Coronary Intervention Reduces Death and Myocardial Infarction in Patients With Multivessel Disease-Meta-Analysis and Meta-Regression of Randomized Trials Causes of delay and associated mortality in patients transferred with ST-segment-elevation myocardial infarction The year in cardiovascular medicine 2020: acute coronary syndromes and intensive cardiac care Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes Quality of Care in Chinese Hospitals: Processes and Outcomes After ST-segment Elevation Myocardial Infarction Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time: a retrospective study

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 FINDINGSAlthough 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.