Related Experiment Video

Updated: Apr 17, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

6.2K

Preventive versus culprit-only percutaneous coronary intervention in ST-elevation myocardial infarction patients with

Yeo-Jeong Song1, Ho-Cheol Shin, Joo-Ii Yang

  • 1Department of Cardiology, Inje University Busan Paik Hospital, Busan, Korea.

Journal of Interventional Cardiology
|February 18, 2015
PubMed

Insights

For ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease, preventive percutaneous coronary intervention (PCI) reduces repeat revascularization but does not improve mortality or myocardial infarction (MI) rates. This strategy is effective in lowering repeat procedures compared to culprit-only PCI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Trials

Background:

  • Complete revascularization in multivessel coronary artery disease (CAD) has shown clinical benefits.
  • The role of preventive percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) with multivessel CAD remains controversial.

Purpose of the Study:

  • To evaluate the clinical outcomes of preventive PCI versus culprit-only PCI in STEMI patients with multivessel CAD.

Main Methods:

  • A systematic review and meta-analysis of randomized trials and observational studies published up to September 2014.
  • Primary endpoint: all-cause mortality. Secondary endpoints: myocardial infarction (MI), repeat revascularization, and major adverse cardiac events (MACE).

Main Results:

  • Preventive PCI significantly reduced repeat revascularization (OR: 0.71) but showed no significant difference in all-cause mortality (OR: 0.99) or MI (OR: 1.08) compared to culprit-only PCI.
  • No significant difference in MACE was observed (OR: 0.80).
  • Stratified analysis indicated a survival benefit for culprit-only PCI over multivessel PCI during the index procedure and lower mortality with staged PCI.

Conclusions:

  • Preventive PCI in STEMI patients with multivessel disease effectively reduces repeat revascularization.
  • This strategy does not offer significant benefits in terms of mortality or MI compared to culprit-only revascularization.
Abstract

More Related Videos

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.9K
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

2.8K

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.8K
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
435
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
499
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
879
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
3.0K
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
623