Islam Y Elgendy1, Dhruv Mahtta2, David Paniagua3. 1. Division of Cardiology, Weill Cornell Medicine-Qatar, Doha, Qatar. iyelgendy@gmail.com. 2. Division of Cardiovascular Medicine, Baylor College of Medicine, Houston, TX, USA. 3. Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Abstract
PURPOSE OF REVIEW: Multivessel coronary artery disease is frequently encountered in patients undergoing primary percutaneous coronary intervention (PCI). Several moderate-sized randomized trials have suggested that complete revascularization of non-culprit stenoses in ST-elevation myocardial infarction (STEMI) patients without cardiogenic shock is associated with improved outcomes driven solely by a reduction in the risk of future revascularization. RECENT FINDINGS: The Complete versus Culprit-only Revascularization to Treat Multi-vessel disease after Early PCI for STEMI (COMPLETE) trial recently showed that a complete revascularization strategy for non-culprit stenoses for STEMI patients without cardiogenic shock, performed either during the index hospitalization or after discharge, reduces the risk of cardiac mortality or myocardial infarction (MI) driven by a reduction in the risk of MI at a median of 3 years. In STEMI patients without cardiogenic shock undergoing primary PCI, a complete revascularization strategy for non-culprit stenoses, performed either during the index hospitalization or shortly after discharge, improves outcomes and should be considered as the default strategy whenever feasible.
PURPOSE OF REVIEW: Multivessel coronary artery disease is frequently encountered in patients undergoing primary percutaneous coronary intervention (PCI). Several moderate-sized randomized trials have suggested that complete revascularization of non-culprit stenoses in ST-elevation myocardial infarction (STEMI) patients without cardiogenic shock is associated with improved outcomes driven solely by a reduction in the risk of future revascularization. RECENT FINDINGS: The Complete versus Culprit-only Revascularization to Treat Multi-vessel disease after Early PCI for STEMI (COMPLETE) trial recently showed that a complete revascularization strategy for non-culprit stenoses for STEMI patients without cardiogenic shock, performed either during the index hospitalization or after discharge, reduces the risk of cardiac mortality or myocardial infarction (MI) driven by a reduction in the risk of MI at a median of 3 years. In STEMI patients without cardiogenic shock undergoing primary PCI, a complete revascularization strategy for non-culprit stenoses, performed either during the index hospitalization or shortly after discharge, improves outcomes and should be considered as the default strategy whenever feasible.
Entities:
Keywords:
Major adverse cardiac events; Mortality; Myocardial infarction; Revascularization