Reperfusion strategies in acute myocardial infarction and multivessel disease. 2017

Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, One Gustave L. Levy Place, Box 1030, New York, New York 10029, USA.

Approximately 50% of patients with ST-segment elevation myocardial infarction (STEMI) have multivessel disease. The optimal reperfusion strategy in these patients is still uncertain. Whether percutaneous coronary intervention (PCI) of only the culprit vessel or a strategy of complete revascularization, either in a simultaneous or staged multivessel PCI approach, should be performed remains unclear. Although a large number of observational studies have mostly shown worse clinical outcomes associated with a multivessel PCI approach, increasing evidence from randomized controlled trials suggests that multivessel PCI is safe, while reducing the need for revascularization in selected patients, compared with culprit vessel-only PCI. However, adequately-powered studies are still needed to determine the best treatment strategy in patients with STEMI and multivessel disease, particularly to demonstrate a reduction in the hard end point of death or myocardial infarction. In this Review, we provide a comprehensive summary of current evidence on the different treatment options for patients with STEMI and multivessel disease, highlighting current guideline recommendations and providing future directions on reperfusion strategies in these patients.

UI MeSH Term Description Entries
D003331 Coronary Vessels The veins and arteries of the HEART. Coronary Arteries,Sinus Node Artery,Coronary Veins,Arteries, Coronary,Arteries, Sinus Node,Artery, Coronary,Artery, Sinus Node,Coronary Artery,Coronary Vein,Coronary Vessel,Sinus Node Arteries,Vein, Coronary,Veins, Coronary,Vessel, Coronary,Vessels, Coronary
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072657 ST Elevation Myocardial Infarction A clinical syndrome defined by MYOCARDIAL ISCHEMIA symptoms; persistent elevation in the ST segments of the ELECTROCARDIOGRAM; and release of BIOMARKERS of myocardial NECROSIS (e.g., elevated TROPONIN levels). ST segment elevation in the ECG is often used in determining the treatment protocol (see also NON-ST ELEVATION MYOCARDIAL INFARCTION). ST Elevated Myocardial Infarction,ST Segment Elevation Myocardial Infarction,STEMI
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017410 Practice Guidelines as Topic Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. Clinical Guidelines as Topic,Best Practices,Best Practice
D062645 Percutaneous Coronary Intervention A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting. Percutaneous Coronary Revascularization,Coronary Intervention, Percutaneous,Coronary Interventions, Percutaneous,Coronary Revascularization, Percutaneous,Coronary Revascularizations, Percutaneous,Intervention, Percutaneous Coronary,Interventions, Percutaneous Coronary,Percutaneous Coronary Interventions,Percutaneous Coronary Revascularizations,Revascularization, Percutaneous Coronary,Revascularizations, Percutaneous Coronary

Related Publications

Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
December 1994, Chest,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
November 1997, European heart journal,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
August 2000, Scandinavian cardiovascular journal : SCJ,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
October 1995, Arquivos brasileiros de cardiologia,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
October 1995, Arquivos brasileiros de cardiologia,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
September 2004, American heart journal,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
November 2011, Nihon rinsho. Japanese journal of clinical medicine,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
November 2008, Current opinion in cardiology,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
March 2008, European heart journal,
Birgit Vogel, and Shamir R Mehta, and Roxana Mehran
May 2003, Nihon rinsho. Japanese journal of clinical medicine,
Copied contents to your clipboard!