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Hemodynamic, Functional, and Clinical Responses to Pulmonary Artery Denervation in Patients With Pulmonary Arterial Hypertension of Different Causes Long-Term Outcomes of Patients With Mediastinal Radiation–Associated Coronary Artery Disease Undergoing Coronary Revascularization With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients With Cancer Systematic Review and Network Meta‐Analysis Comparing Bifurcation Techniques for Percutaneous Coronary Intervention Implications of the local hemodynamic forces on the formation and destabilization of neoatherosclerotic lesions Management and outcomes of patients with left atrial appendage thrombus prior to percutaneous closure Transseptal puncture versus patent foramen ovale or atrial septal defect access for left atrial appendage closure Evolving insights into the role of local shear stress in late stent failure from neoatherosclerosis formation and plaque destabilization 2015 ACC/HRS/SCAI Left Atrial Appendage Occlusion Device Societal Overview Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes
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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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