Percutaneous coronary intervention of culprit and non-culprit coronary arteries in acute ST-elevation MI may improve outcomes

Commentary on: Wald DS, Morris JK, Wald NJ, et al.. Randomised trial of preventive angioplasty in myocardial infarction. N Engl J Med 2013;369:1115–23. Context The paramount goal of the treatment for acute ST-elevation myocardial infarction (STEMI) is the emergent restoration of blood flow through percutaneous coronary intervention (PCI) of the infarct-related or ‘culprit artery’, generally identified as an occluded vessel from a thrombotic lesion. However, multivessel coronary artery disease (CAD) is frequently present in patients with STEMI and portends a worse prognosis. The optimal revascularisation strategy for non-culprit coronary lesions in STEMI is unclear.1 The current American College of Cardiology Foundation/American Heart Association and European Society of Cardiology guidelines advise against PCI of non-infarct vessels in the acute setting unless haemodynamic compromise is present, owing to a lack of evidence for its benefit in small, mostly observational studies.2 3 The guidelines...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Radiology, Clinical diagnostic tests Therapeutics Source Type: research