Abstract
Coronary artery disease is the leading cause of illness and death in older adults. Around 40% to 50% of patients with ST-segment elevation myocardial infarction (STEMI) have multiple coronary artery disease. Multiple vessel coronary disease has been shown to improve cardiac outcomes and survival in patients who have undergone complete revascularization (CR) versus patients who have undergone only incomplete revascularization (ICR). When coronary angiography and PCI of the source of the infarction are performed on patients with STEMI, the risk of adverse cardiac death or myocardial infarction is significantly reduced. Additional research is needed to determine the efficacy of PCI of non-critical lesions. However, following procedures such as CABG or PCI, these procedures may be impossible to perform due to a variety of personal, anatomical, technical, and logistical barriers. In this review, we discussed about benefit of complete revascularization in patient acute coronary syndrome (ACS) with multivessel disease and which patient can be performed aggressive revascularization to achieved CR in clinical practice.
Highlights
About half of patients with segment elevation myocardial infarction (STEMI) and two-thirds of patients with non–ST-segment elevation acute coronary syndromes (NSTEACS) have additional stenosis distal to the infarct-related artery
Cavendor et al found that complete revascularization (CR) was associated with a significantly higher risk of mortality (7.9% vs 5.1%, p=0.01), Both three randomized clinical trials and eight thousand patients in total (CR, 7,498 patients; Culprit-only revascularization (COR), 8,240) were included in the data review by Dr Lu, along with non-randomized studies (N = 10,999) that included 6,997 subjects undergoing CR and 7,509 subjects undergoing CABG (COR). creativity is linked to an increased risk of death and kidney disease.[7]
There was a decrease in the number of in-hospital significant incidence of major adverse cardiac events and mortality which was associated with the COR strategy at one year
Summary
About half of patients with STEMI and two-thirds of patients with non–ST-segment elevation acute coronary syndromes (NSTEACS) have additional stenosis distal to the infarct-related artery. Cardiogenic shock exacerbates the mortality associated with acute myocardial infarction when prompt revascularization, including percutaneous coronary intervention, is performed (AMI). Objective: In this review, we discussed the benefit of complete revascularization in acute coronary syndrome (ACS) patients with multivessel disease and which patient can be performed aggressive revascularization to achieved CR in clinical practice. Additional research is needed to determine the efficacy of PCI in non-critical lesions. Following procedures such as CABG or PCI, these procedures may be impossible to perform due to a variety of personal, anatomical, technical, and logistical barriers. CR has been demonstrated in several studies to result in decreased rehospitalization and the need for repeated revascularization in the subsequent period in ACS patients with a low SYNTAX score and no cardiogenic shock
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