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Current Smoking and Prognosis After Acute ST-Segment Elevation Myocardial Infarction: New Pathophysiological Insights Switching P2Y12-receptor inhibitors in patients with coronary artery disease An open-Label, 2 × 2 factorial, randomized controlled trial to evaluate the safety of apixaban vs. vitamin K antagonist and aspirin vs. placebo in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary intervention: Rationale and design of the AUGUSTUS trial Biolimus-A9 polymer-free coated stent in high bleeding risk patients with acute coronary syndrome: a Leaders Free ACS sub-study Macrophage MST1/2 Disruption Impairs Post-Infarction Cardiac Repair via LTB4 Systems of Care for ST-Segment–Elevation Myocardial Infarction: A Policy Statement From the American Heart Association Healed Culprit Plaques in Patients With Acute Coronary Syndromes 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines Complete Revascularization Versus Culprit Lesion Only in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A DANAMI-3-PRIMULTI Cardiac Magnetic Resonance Substudy Advances in Clinical Cardiology 2020: A Summary of Key Clinical Trials
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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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