Complete Versus Culprit-Only Revascularization Strategies to Treat Multivessel Disease after Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction

Abstract

Background: Acute myocardial infarction with multivessel disease represents a higher cardiovascular risk and revascularization strategy in such patients remains a subject of conflict. The aim of our study was to assess the potential benefit of complete revascularization as compared to culprit vessel only revascularization in ST-segment elevation myocardial infarction (STEMI) patients who has multivessel disease (MVD). Methods: The current study is a single center prospective study conducted on 150 Patients presented with acute ST-segment elevation myocardial infarction to emergency department (ED) and cardiac care unit (CCU) in Nasr city hospital and according to revascularization strategy, patients were divided into two groups; I: patients received complete revascularization before hospital discharge and Group II: patients receiving culprit-only revascularization. Results: There was significant lower MACE in group I (p < 0.05). the occurrence of non-ST segment acute coronary syndrome (NSTE-ACS) as well as the need for ischemia-driven revascularization were significantly lower in the complete revascularization group (p=0.028 & p=0.008) respectively. Conclusion: in STEMI patients with multivessel disease, complete revascularization as compared to culprit-only revascularization strategy reduced MACE and improved outcome.