Display options
Cite
Patel S, Bailey SR. Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged. Curr Cardiol Rep. 2017;19(10):93doi: 10.1007/s11886-017-0906-2.
Patel, S., & Bailey, S. R. (2017). Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged. Current cardiology reports, 19(10), 93. https://doi.org/10.1007/s11886-017-0906-2
Patel, Shalin, and Bailey, Steven R. "Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged." Current cardiology reports vol. 19,10 (2017): 93. doi: https://doi.org/10.1007/s11886-017-0906-2
Patel S, Bailey SR. Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged. Curr Cardiol Rep. 2017 Aug 24;19(10):93. doi: 10.1007/s11886-017-0906-2. PMID: 28840487.
Copy Download .nbib Format: NLM
Share it on

Curr Cardiol Rep. 2017 Aug 24;19(10):93. doi: 10.1007/s11886-017-0906-2.

Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged.

Current cardiology reports

Shalin Patel, Steven R Bailey

Affiliations

  1. From the Janey Briscoe Center of Excellence for Cardiovascular Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78232, USA.
  2. From the Janey Briscoe Center of Excellence for Cardiovascular Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78232, USA. [email protected].

PMID: 28840487 DOI: 10.1007/s11886-017-0906-2

Abstract

PURPOSE OF REVIEW: This review will address the clinical conundrum of those who may derive clinical benefit from complete revascularization of coronary stenosis that are discovered at the time of ST segment elevation myocardial infarction (STEMI). The decision to revascularize additional vessels with angiographic stenosis beyond the culprit lesion remains controversial, as does the timing of revascularization.

RECENT FINDINGS: STEMI patients represent a high-risk patient population that have up to a 50% prevalence of multivessel disease. Multivessel disease represents an important risk factor for short- and long-term morbidity and mortality. Potential benefits of multivessel PCI for STEMI might include reduced short- and long-term mortality, revascularization, reduced resource utilization, and costs. Which population will benefit and what the optimal timing of revascularization in the peri-MI period remains controversial. Consideration of multivessel revascularization in the setting of STEMI may occur in up to one half of STEMI patients. Evaluation of the comorbidities including diabetes, extent of myocardium at risk, lesion complexity, ventricular function, and risk factors for complications such as contrast induced nephropathy which is important in determining the appropriate care pathway.

Keywords: CABG; Complete revascularization; Diabetes; FFR; Multivessel disease; PCI; Physiologic assessment; Primary percutaneous coronary intervention; ST segment elevation myocardial infarction (STEMI); Single vessel; Staged

References

  1. Open Heart. 2014 Feb 15;1(1):e000012 - PubMed
  2. JACC Cardiovasc Interv. 2010 Dec;3(12):1274-81 - PubMed
  3. Circ Cardiovasc Interv. 2015 Apr;8(4):null - PubMed
  4. Heart. 2015 Aug;101(15):1233-9 - PubMed
  5. Heart Lung Circ. 2015 Apr;24(4):327-34 - PubMed
  6. Neth Heart J. 2012 Sep;20(9):347-53 - PubMed
  7. Int J Cardiol. 2011 Oct 6;152(1):97-9 - PubMed
  8. J Interv Cardiol. 2015 Feb;28(1):1-13 - PubMed
  9. Am Heart J. 1991 Apr;121(4 Pt 1):1042-9 - PubMed
  10. J Am Coll Cardiol. 2015 Mar 17;65(10 ):963-72 - PubMed
  11. J Am Coll Cardiol. 2002 Sep 4;40(5):911-6 - PubMed
  12. Catheter Cardiovasc Interv. 2015 Oct;86 Suppl 1:S15-22 - PubMed
  13. J Am Coll Cardiol. 1991 Dec;18(7):1594-601 - PubMed
  14. EuroIntervention. 2010 Apr;5(8):968-75 - PubMed
  15. Am Heart J. 2014 Jan;167(1):1-14.e2 - PubMed
  16. J Am Coll Cardiol. 2011 Aug 9;58(7):692-703 - PubMed
  17. Am Heart J. 2016 Sep;179:157-65 - PubMed
  18. J Thromb Thrombolysis. 2011 Feb;31(2):217-25 - PubMed
  19. JAMA. 2014 Nov 19;312(19):2019-27 - PubMed
  20. Kaohsiung J Med Sci. 2013 Mar;29(3):140-9 - PubMed
  21. PLoS One. 2014 Mar 20;9(3):e92316 - PubMed
  22. Clin Cardiol. 2014 Dec;37(12):765-72 - PubMed
  23. J Am Heart Assoc. 2015 Dec 14;4(12):null - PubMed
  24. Can J Cardiol. 2016 Dec;32(12 ):1542-1551 - PubMed
  25. Int J Cardiol. 2015 Jan 20;179:225-7 - PubMed
  26. Am Heart J. 2013 Oct;166(4):684-693.e1 - PubMed
  27. Heart. 2015 Aug;101(16):1309-17 - PubMed
  28. J Am Coll Cardiol. 2016 Sep 6;68(10 ):1066-81 - PubMed
  29. Am Heart J. 2011 Mar;161(3):500-507.e1 - PubMed
  30. Heart. 2010 May;96(9):662-7 - PubMed
  31. Int J Cardiol. 2015 Jan 20;179:552-7 - PubMed
  32. J Am Coll Cardiol. 1999 Oct;34(4):974-82 - PubMed
  33. J Am Coll Cardiol. 2016 Mar 15;67(10):1235-50 - PubMed
  34. Am J Cardiol. 2015 Jun 1;115(11):1481-6 - PubMed
  35. Lancet. 2015 Aug 15;386(9994):665-71 - PubMed
  36. Cardiovasc Revasc Med. 2014 Nov-Dec;15(8):408-13 - PubMed
  37. JACC Cardiovasc Interv. 2017 Jan 9;10 (1):11-23 - PubMed
  38. Catheter Cardiovasc Interv. 2011 Feb 1;77(2):163-70 - PubMed
  39. J Am Coll Cardiol. 2013 Jan 29;61(4):e78-140 - PubMed
  40. Int J Cardiovasc Intervent. 2004;6(3-4):128-33 - PubMed
  41. Int J Cardiol. 2015 Jan 15;178:171-4 - PubMed
  42. Am Heart J. 2015 Dec;170(6):1133-9 - PubMed
  43. Eur Heart J. 2014 Oct 1;35(37):2541-619 - PubMed
  44. Neth Heart J. 2015 Apr;23(4):224-31 - PubMed
  45. Catheter Cardiovasc Interv. 2016 Oct;88(4):501-505 - PubMed
  46. Am J Cardiol. 2011 May 1;107(9):1300-10 - PubMed
  47. J Am Coll Cardiol. 1990 Nov;16(5):1089-96 - PubMed

MeSH terms

Publication Types