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Current Status of Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Multivessel

Min Chul Kim1, Myung Ho Jeong1, Sang Hyung Kim1

  • 1Department of Cardiovascular Medicine, Heart Center, Chonnam National University Hospital, Gwangju, Korea.

Korean Circulation Journal
|May 31, 2014
PubMed

Insights

For ST-elevation myocardial infarction (STEMI) patients with multivessel disease, this review examines the benefits and risks of complete revascularization during primary percutaneous coronary intervention (PCI) versus treating only the culprit artery.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine
  • Acute Coronary Syndromes

Background:

  • Primary percutaneous coronary intervention (PCI) is standard for ST-segment elevation myocardial infarction (STEMI).
  • Multivessel coronary artery disease (CAD) is found in ~50% of STEMI patients undergoing primary PCI.
  • Optimal revascularization strategy in STEMI with multivessel CAD remains debated.

Purpose of the Study:

  • To review the current evidence on multivessel PCI in STEMI patients.
  • To discuss the risks and benefits of complete versus culprit-only revascularization.
  • To propose an optimal revascularization strategy.

Main Methods:

  • Literature review of previous studies on multivessel PCI in STEMI.
  • Analysis of clinical outcomes comparing different revascularization strategies.
  • Consideration of patient factors like cardiogenic shock and myocardial viability.

Main Results:

  • Revascularization of the infarct-related artery alone is effective for STEMI.
  • Studies show efficacy for multivessel PCI, either primary or staged.
  • Clinical decision-making requires careful assessment of risks and benefits.

Conclusions:

  • Multivessel PCI in STEMI requires individualized strategies.
  • Consideration of cardiogenic shock and myocardial viability is crucial.
  • Optimal strategy balances complete revascularization with procedural risks.

Keywords:
Coronary artery diseaseMyocardial infarctionPercutaneous coronary intervention

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