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Regurgitant Volume/Left Ventricular End-Diastolic Volume Ratio: Prognostic Value in Patients With Secondary Mitral Regurgitation Why NOBLE and EXCEL Are Consistent With Each Other and With Previous Trials Prasugrel versus clopidogrel in patients with acute coronary syndromes Two-year outcomes following unprotected left main stenting with first vs new-generation drug-eluting stents: the FINE registry. EuroIntervention. Active SB-P Versus Conventional Approach to the Protection of High-Risk Side Branches: The CIT-RESOLVE Trial Positive remodeling at 3 year follow up is associated with plaque-free coronary wall segment at baseline: a serial IVUS study Successful bailout stenting strategy against lethal coronary dissection involving left main bifurcation Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II Noninvasive Imaging for the Evaluation of Diastolic Function: Promises Fulfilled
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Review Article2017 Aug 24;19(10):93.

JOURNAL：Curr Cardiol Rep. Article Link

Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged

Patel S, Bailey SR. Keywords: CABG; Complete revascularization; Diabetes; FFR; Multivessel disease; PCI; Physiologic assessment; Primary percutaneous coronary intervention; ST segment elevation myocardial infarction (STEMI); Single vessel; Staged

ABSTRACT

PURPOSE OF REVIEW - This review will address the clinical conundrum of those who may derive clinical benefit from complete revascularization of coronary stenosis that are discovered at the time of ST segment elevation myocardial infarction (STEMI). The decision to revascularize additional vessels with angiographic stenosis beyond the culprit lesion remains controversial, as does the timing of revascularization.

 

RECENT FINDINGS - STEMI patients represent a high-risk patient population that have up to a 50% prevalence of multivessel disease. Multivessel disease represents an important risk factor for short- and long-term morbidity and mortality. Potential benefits of multivessel PCI for STEMI might include reduced short- and long-term mortality, revascularization, reduced resource utilization, and costs. Which population will benefit and what the optimal timing of revascularization in the peri-MI period remains controversial. Consideration of multivessel revascularization in the setting of STEMI may occur in up to one half of STEMI patients. Evaluation of the comorbidities including diabetes, extent of myocardium at risk, lesion complexity, ventricular function, and risk factors for complications such as contrast induced nephropathy which is important in determining the appropriate care pathway.

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