Management and outcomes of significant non-culprit coronary artery lesions in STEMI: a retrospective cohort study

Abstract

BackgroundIn the setting of ST-elevation myocardial infarction (STEMI) and multi-vessel disease (MVD), guidelines recommend revascularization of the culprit lesion (CL) only, due to poor evidence supporting intervention in non-culprit lesions (non-CLs) during the same index procedure. Debate over management for significant non-CLs is of interest i.e. medical management vs. percutaneous revascularization. We describe a cohort of patients with STEMI and MVD and compare the occurrence of major adverse cardiac events (MACE) by therapeutic strategies for non-CLs with regard to follow-up outcomes.

Predicting ischemic mitral regurgitation in patients with acute ST-elevation myocardial infarction: Does time to reperfusion really matter and what is the role of collateral circulation?

“…All patients in our study were treated with primary PCI for culprit lesion only. Conventional management strategies for treating STEMI patients with multi-vessel CAD may vary from complete interventional revascularization including non-culprit lesions during index procedure to medical therapy, staged PCI or subsequent surgical revascularization [31][32][33]. Impact of completeness of revascularization and residual ischemic myocardial burden on ischemic MR is a potential direction for future investigations.…”