Related Experiment Video

Updated: Mar 11, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

9.7K

Complete revascularization versus culprit-only revascularization in ST-segment elevation myocardial infarction and

Chong-Hui Wang1, Shu-Yang Zhang1, Xiao-Feng Jin1

  • 1Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

International Journal of Cardiology
|December 2, 2016
PubMed

Insights

Complete revascularization (CR) is superior to culprit-only revascularization (COR) for ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease. CR significantly reduces major adverse cardiac events and repeat revascularization, offering better patient outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Research

Background:

  • ST-segment elevation myocardial infarction (STEMI) with multivessel disease presents complex treatment challenges.
  • Percutaneous coronary intervention (PCI) strategies include complete revascularization (CR) and culprit-only revascularization (COR).
  • The optimal PCI strategy for STEMI patients with multivessel disease remains debated.

Purpose of the Study:

  • To compare the clinical outcomes of CR versus COR in patients with STEMI and multivessel disease undergoing primary PCI.
  • To determine the more appropriate revascularization strategy based on meta-analysis of randomized controlled trials (RCTs).

Main Methods:

  • A meta-analysis of published RCTs was conducted, searching PubMed, EMBASE, and CENTRAL databases.
  • Eight RCTs involving 2060 patients (1080 CR, 980 COR) with a follow-up of 6-38 months were included.
  • Trial sequential analysis was performed to assess the robustness of the findings.

Main Results:

  • Overall, CR significantly reduced major adverse cardiac events (MACE) and repeat revascularization compared to COR.
  • Immediate CR (ICR) further reduced MACE, all-cause death/MI, non-fatal MI, and repeat revascularization versus COR.
  • Staged CR (SCR) only showed a significant reduction in MACE compared to COR.
  • No significant differences were observed in contrast-induced nephropathy, major hemorrhage, or stroke between CR and COR.
  • Trial sequential analysis confirmed firm evidence for MACE and revascularization benefits with CR in the overall population and ICR subgroup.

Conclusions:

  • Complete revascularization (CR) is a preferable strategy to culprit-only revascularization (COR) in STEMI patients with multivessel disease undergoing primary PCI.
  • CR, particularly immediate CR, offers significant benefits in reducing adverse cardiac events and the need for repeat procedures.
  • The safety profile regarding complications like nephropathy and hemorrhage is comparable between CR and COR.

Keywords:
Complete revascularizationCulprit-only revascularizationMultivessel diseaseST-segment elevation myocardial infarction

More Related Videos

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

2.6K
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

26.5K

Related Concept Videos

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...
357
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...
1.4K
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...
472
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...
374
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...
2.0K