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急性冠脉综合征

Abstract

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Predicting Major Adverse Events in Patients With Acute Myocardial Infarction Prevalence of Angina Among Primary Care Patients With Coronary Artery Disease Optimum Blood Pressure in Patients With Shock After Acute Myocardial Infarction and Cardiac Arrest Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged Association of Thrombus Aspiration With Time and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction: A Post Hoc Analysis of the Randomized TOTAL Trial Multivessel PCI Guided by FFR or Angiography for Myocardial Infarction Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With STEMI: A Cardiac Magnetic Resonance Study Homeostatic Chemokines and Prognosis in Patients With Acute Coronary Syndromes
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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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