Beyond ischaemia: is there a place for physiologic and anatomic evaluations of coronary lesions?

EuroIntervention 2021;17:e267-e268. DOI: 10.4244/EIJV17I4A46

Gilles Montalescot
Gilles Montalescot1, MD, PhD; Michel Zeitouni1, MD
1. Sorbonne Université, ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France
In 2012, the residual SYNTAX score emerged as an efficient method to evaluate the contribution of non-culprit coronary lesions – based on their anatomic features – to the remaining cardiovascular risk of patients with multivessel disease treated with primary percutaneous coronary intervention (PCI)1. The residual SYNTAX score has been well validated across different clinical presentations including the most complex such as myocardial infarction (MI) with cardiogenic shock2. Then, landmark trials demonstrated that non-ischaemia-guided PCI of non-culprit lesions was superior to medical treatment only in patients with ST-elevation myocardial infarction (STEMI), but with inconsistent reductions in hard endpoints such as recurrent MI ...

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