Complete revascularization in acute myocardial infarction: a clinical review

Abstract

In patients with ST segment elevation and non-ST elevation myocardial infarction (MI), multivessel (MV) coronary artery disease is found in approximately 50%, leading to worse clinical outcomes. Recent data have suggested that complete revascularization with MV percutaneous coronary intervention is associated with a reduced risk of major adverse cardiovascular events as compared to culprit vessel-only revascularization. However, the optimal timing of MV intervention, appropriate non-culprit lesion assessment, and the best revascularization strategy in specific subsets such as cardiogenic shock remain to be established. This review article summarizes current evidence on revascularization strategies in patients with acute MI and MV disease.

Effects of dual antiplatelet therapy de-escalation on the prognosis of acute coronary syndrome patients at high risk of ischemia who underwent percutaneous coronary intervention

“…A review of 21 related randomized controlled trials (RCTs) suggests that complete revascularization can reduce the incidence of MACCEs in patients with acute myocardial infarction, [7] which was similar to our outcome of the Cox regression. It is suggested that for patients at high risk of ischemia with multiple vessel lesions, complete revascularization should be performed while fully evaluating the characteristics of the lesions.…”

Complications and Outcomes of Impella Treatment in Cardiogenic Shock Patients With and Without Acute Myocardial Infarction

“…For instance, patients with AMI are likely to be older and have more comorbidities as shown in the present study, although they have an immediate therapeutic option such as primary percutaneous coronary intervention. 15 , 16 , 17 Differences in a diagnostic and therapeutic time frame may lead to different outcomes in patients with and without AMI. In this study, indeed, patients with AMI received the Impella earlier after hospital arrival than those without, suggesting that the devices were placed in an emergency situation in AMI than in non‐AMI.…”