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

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Therapeutics
Randomised controlled trial
Percutaneous coronary intervention of culprit and non-culprit coronary arteries in acute ST-elevation MI may improve outcomes
  1. Stuart H Chen,
  2. Anjan K Chakrabarti
  1. Department of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to : Dr Stuart H Chen, Department of Cardiology, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Baker 4, Boston MA 02215, USA; shchen{at}bidmc.harvard.edu

https://doi.org/10.1136/eb-2013-101618

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    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.OpenUrlCrossRefPubMedWeb of Science

    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 …

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    Footnotes

    • Competing interests None.