Debate

DOI: 10.4244/EIJ-E-23-00045

Complete revascularisation should be immediate in STEMI: pros and cons

Adnan Kastrati1,2, MD; Thorsten Kessler1,2, MD; Riccardo Rinaldi3, MD; Salvatore Brugaletta3, MD, PhD

Multivessel coronary artery disease often occurs in patients presenting with ST-segment elevation myocardial infarction (STEMI). Current European guidelines on acute coronary syndromes (ACS) recommend complete revascularisation in such patients, but there is no consensus on the optimal timing. As such, percutaneous coronary intervention (PCI) of the non-infarct-related arteries (IRAs) can be performed either immediately (i.e., during the primary PCI) or in a staged (i.e., within 45 days) procedure. Although an immediate complete revascularisation can reduce the use of contrast medium and radiation and can be more practical in off-hours procedures, there are factors that favour a staged approach, including the high thrombo-inflammatory burden, an impaired evaluation of non-IRAs and the lack of information about patient history and comorbidities. Both these strategies have pros and cons, and the optimal timing for complete revascularisation remains a subject of debate.

Pros Adnan Kastrati, MD; Thorsten Kessler, MD

Primary PCI with treatment of the culprit lesion is the standard of care for patients with STEMI1. Existing evidence supports the benefits of complete revascularisation (CR) over culprit lesion-only PCI in STEMI with multiple vessel...

Sign in to read
the full article

Forgot your password?
No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Volume 20 Number 3
Feb 5, 2024
Volume 20 Number 3
View full issue


Key metrics

On the same subject

10.4244/EIJV16I3A34 Jun 25, 2020
Complete revascularisation in the STEMI patient: is it worth the effort?
Gershlick A and Banning AS
free

State-of-the-Art Review

10.4244/EIJ-D-20-00957 Jun 25, 2021
Completeness of revascularisation in acute coronary syndrome patients with multivessel disease
Paradies V et al
free

10.4244/EIJV14I1A3 May 20, 2018
P2Y12 inhibition in STEMI: early, strong or both?
Mangiacapra F and Di Sciascio G
free
Trending articles
188.3

State-of-the-Art Review

10.4244/EIJ-D-21-01034 Jun 3, 2022
Management of in-stent restenosis
Alfonso F et al
free
170.15

Translational research

10.4244/EIJ-D-21-00824 May 15, 2022
Bench test and in vivo evaluation of longitudinal stent deformation during proximal optimisation
Toth GG et al
free
159.45

Expert review

10.4244/EIJ-D-21-00690 May 15, 2022
Crush techniques for percutaneous coronary intervention of bifurcation lesions
Moroni F et al
free
128.28

State-of-the-Art

10.4244/EIJ-D-22-00776 Apr 3, 2023
Computed tomographic angiography in coronary artery disease
Serruys PW et al
free
108.75

Viewpoint

10.4244/EIJ-E-22-00007 May 15, 2022
TAVI at 20: how a crazy idea led to a clinical revolution
Eltchaninoff H et al
free
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 6.2
2022 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2023)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2024 Europa Group - All rights reserved