PMID- 28537939
OWN - NLM
STAT- MEDLINE
DCOM- 20180514
LR  - 20180514
IS  - 1473-5830 (Electronic)
IS  - 0954-6928 (Linking)
VI  - 28
IP  - 6
DP  - 2017 Sep
TI  - Current perspectives on revascularization in multivessel ST elevation myocardial 
      infarction.
PG  - 498-506
LID - 10.1097/MCA.0000000000000496 [doi]
AB  - Up to 50% of patients presenting with ST elevation myocardial infarction (STEMI) 
      are found to have multivessel coronary artery disease. These patients have a 
      worse prognosis compared with the overall STEMI population. Two revascularization 
      strategies are possible for these patients: treating the infarct-related artery 
      percutaneous coronary intervention (IRA-PCI) only or achieving Complete 
      revascularization (CR), either through an immediate multivessel PCI during the 
      index angiography or during a second-staged procedure. Until recently, most 
      clinical data on this issue were derived from observational studies - which all 
      showed a clear advantage to the IRA-PCI over the CR approach. Over the past few 
      years, several groundbreaking randomized trials have suggested that the CR 
      approach may be at least equivalent, and perhaps superior, to the IRA-PCI 
      strategy. This has caused a paradigm shift reflected in the recent US and 
      European guidelines. However, there is still uncertainty on the optimal timing 
      for achieving CR (immediate/during the index admission/during a subsequent 
      elective admission) and several other important issues in terms of 
      revascularization: the extent of revascularization needed to achieve maximal 
      benefit, the optimal means to evaluate the significance of intermediate coronary 
      stenosis in the context of acute myocardial infarction, and the best approach to 
      treat chronic total occlusions have not been thoroughly examined, and are the 
      subject of an ongoing debate.
FAU - Witberg, Guy
AU  - Witberg G
AD  - aDepartment of Cardiology, Rabin Medical Center, Petach-Tikva bThe Sackler 
      Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Kornowski, Ran
AU  - Kornowski R
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
SB  - IM
MH  - Chi-Square Distribution
MH  - Coronary Angiography
MH  - Coronary Artery Disease/diagnostic imaging/mortality/physiopathology/*therapy
MH  - Coronary Occlusion/diagnosis/mortality/physiopathology/*therapy
MH  - Coronary Stenosis/diagnostic imaging/mortality/physiopathology/*therapy
MH  - Humans
MH  - Odds Ratio
MH  - *Percutaneous Coronary Intervention/adverse effects/mortality
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/diagnostic 
      imaging/mortality/physiopathology/*therapy
MH  - Treatment Outcome
EDAT- 2017/05/26 06:00
MHDA- 2018/05/15 06:00
CRDT- 2017/05/25 06:00
PHST- 2017/05/26 06:00 [pubmed]
PHST- 2018/05/15 06:00 [medline]
PHST- 2017/05/25 06:00 [entrez]
AID - 10.1097/MCA.0000000000000496 [doi]
PST - ppublish
SO  - Coron Artery Dis. 2017 Sep;28(6):498-506. doi: 10.1097/MCA.0000000000000496.