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[ST segment elevation myocardial infarction: what is the best timing for revascularization of non-culprit lesions?]

B Assous1, E Puymirat2

  • 1Department of cardiology, université Paris-Descartes, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75015 Paris, France.

Annales De Cardiologie Et D'Angeiologie
|May 20, 2014
PubMed

Insights

For ST-elevation myocardial infarction (STEMI) patients with multi-vessel disease, the optimal timing for secondary revascularization of non-culprit lesions remains unclear. This review examines current evidence on when to perform these additional procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Medicine

Context:

  • ST-elevation myocardial infarction (STEMI) frequently presents with multi-vessel coronary artery disease, affecting approximately 50% of patients.
  • Current guidelines primarily advocate for revascularization of the culprit lesion during the index procedure for STEMI, with exceptions for cardiogenic shock.

Purpose:

  • To review and discuss the optimal timing for secondary revascularization of non-culprit lesions in patients with STEMI and multi-vessel disease.
  • To analyze the existing evidence regarding the benefits and risks associated with delayed revascularization strategies.

Summary:

  • While the benefit of revascularizing functionally significant non-culprit lesions in STEMI is established, the ideal timing is debated.
  • This review synthesizes current literature on the timing of secondary revascularization procedures for associated functional lesions in STEMI patients with multi-vessel disease.

Impact:

  • Informing clinical decision-making for STEMI management regarding multi-vessel disease.
  • Potentially optimizing patient outcomes by clarifying secondary revascularization strategies.
  • Guiding future research on the timing of interventions for non-culprit lesions in STEMI.

Keywords:
AngioplastieCulprit lesionLésion coupablePercutaneous coronary interventionRevascularisationRevascularizationST-elevation myocardial infarctionSyndrome coronarien aigu

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