Complete revascularization in acute myocardial infarction: a clinical review

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiovascular Medicine

Background:

• Multivessel (MV) coronary artery disease affects ~50% of myocardial infarction (MI) patients, correlating with poorer outcomes.
• Complete revascularization via MV percutaneous coronary intervention shows promise in reducing major adverse cardiovascular events compared to culprit vessel-only treatment.

Purpose of the Study:

• To review current evidence on revascularization strategies for acute MI patients with MV disease.
• To highlight areas needing further investigation, including optimal timing and lesion assessment for MV intervention.

Main Methods:

• Literature review of recent data and evidence on revascularization strategies.
• Synthesis of findings related to complete vs. culprit vessel-only revascularization.
• Identification of knowledge gaps in specific patient subsets like cardiogenic shock.

Main Results:

• Complete MV percutaneous coronary intervention is associated with reduced major adverse cardiovascular events.
• Optimal timing and assessment of non-culprit lesions remain areas for further research.
• Specific strategies for subsets like cardiogenic shock are not yet established.

Conclusions:

• Revascularization strategies for acute MI with MV disease are evolving.
• Further research is crucial to define optimal timing, lesion assessment, and tailored approaches for specific patient groups.