Acute myocardial infarction in a patient with multivessel disease – management strategies Review article
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Published:
Jan 9, 2018
Keywords:
coronary heart disease, reperfusion, revascularization, ST-segment elevation myocardial infarction
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Abstract
Even half of patients with ST-segment elevation myocardial infarction have lesions in several coronary arteries. Since years discussions are carried out regarding optimal treatment strategy in this group of patients. In the newest European Society of Cardiology guidelines concerning management of this type of myocardial infarction class IIa recommendation with level of evidence A gained the recommendation to perform revascularization of non-culprit lesions before discharge, if the patient has multivessel coronary disease and is hospitalized due to ST-segment elevation myocardial infarction. Here we present review of both, observational as well as randomized controlled trials regarding this issue.
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Kern , A., Zaleska , M., Możeńska , O., & Bil , J. (2018). Acute myocardial infarction in a patient with multivessel disease – management strategies. Cardiology in Practice, 11(4), 21-27. Retrieved from https://journalsmededu.pl/index.php/kwp/article/view/1233
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
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10. Santos A.R., Picarra B.C., Celeiro M. et al.: Multivessel approach in ST-elevation myocardial infarction: impact on in-hospital morbidity and mortality. Rev. Port. Cardiol. 2014; 33(2): 67-73. http://doi.org/10.1016/j.repc.2013.07.015.
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12. Abe D., Sato A., Hoshi T. et al.: Initial culprit-only versus initial multivessel percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction: results from the Ibaraki Cardiovascular Assessment Study registry. Heart and Vessels 2014; 29(2): 171-177.
13. Iqbal M.B., Ilsley C., Kabir T. et al.: Culprit Vessel Versus Multivessel Intervention at the Time of Primary Percutaneous Coronary Intervention in Patients With ST-Segment – Elevation Myocardial Infarction and Multivessel Disease. Circulation: Cardiovascular Quality and Outcomes 2014; 7(6): 936-943.
14. Braga C.G., Cid-Álvarez A.B., Diéguez A.R. et al.: Multivessel Versus Culprit-only Percutaneous Coronary Intervention in ST-segment Elevation Acute Myocardial Infarction: Analysis of an 8-year Registry. Revista Española de Cardiología (English Edition) 2017; 70(6): 425-432.
15. Corpus R.A., House J.A., Marso S.P. et al.: Multivessel percutaneous coronary intervention in patients with multivessel disease and acute myocardial infarction. Am. Heart J. 2004; 148(3): 493-500. http://doi.org/10.1016/j.ahj.2004.03.051.
16. Kim M.C., Jeong M.H., Park K.H. et al.: Three-year clinical outcomes of staged, ad hoc and culprit-only percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction and multivessel disease. Int. J. Cardiol. 2014; 176(2): 505-507. http://doi.org/10.1016/j.ijcard.2014.07.054.
17. Varani E., Balducelli M., Aquilina M. et al.: Single or multivessel percutaneous coronary intervention in ST-elevation myocardial infarction patients. Catheter Cardiovasc. Interv. 2008; 72(7): 927-933. http://doi.org/10.1002/ccd.21722.
18. Russo J.J., Wells G.A., Chong A.Y. et al.: Safety and Efficacy of Staged Percutaneous Coronary Intervention During Index Admission for ST-Elevation Myocardial Infarction With Multivessel Coronary Disease (Insights from the University of Ottawa Heart Institute STEMI Registry). Am. J. Cardiol. 2015; 116(8): 1157-1162. http://doi.org/10.1016/j.amjcard.2015.07.029.
19. Ma L.X., Lu Z.H., Wang L. et al.: Culprit vessel only versus “one-week” staged percutaneous coronary intervention for multivessel disease in patients presenting with ST-segment elevation myocardial infarction. J. Geriatr. Cardiol. 2015; 12(3): 226-231. http://doi.org/10.11909/j.issn.1671-5411.2015.03.001.
20. Lee H.W., Hong T.J., Yang M.J. et al.: Comparison of infarct-related artery vs multivessel revascularization in ST-segment elevation myocardial infarction with multivessel disease: analysis from Korea Acute Myocardial Infarction Registry. Cardiol. J. 2012; 19(3): 256-266.
21. Chen H.C., Tsai T.H., Fang H.Y. et al.: Benefit of revascularization in non-infarct-related artery in multivessel disease patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Int. Heart J. 2010; 51(5): 319-324.
22. Toyota T., Shiomi H., Taniguchi T. et al.: Culprit Vessel-Only vs. Staged Multivessel Percutaneous Coronary Intervention Strategies in Patients With Multivessel Coronary Artery Disease Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction. Circ. J. 2016; 80(2): 371-378. http://doi.org/10.1253/circj.CJ-15-0493.
23. Manari A., Varani E., Guastaroba P. et al.: Long‐term outcome in patients with ST segment elevation myocardial infarction and multivessel disease treated with culprit‐only, immediate, or staged multivessel percutaneous revascularization strategies: Insights from the REAL registry. Catheter. Cardiovasc. Interv. 2014; 84(6): 912-922.
24. Hannan E.L., Samadashvili Z., Walford G. et al.: Culprit vessel percutaneous coronary intervention versus multivessel and staged percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel disease. JACC Cardiovasc. Interv. 2010; 3(1): 22-31. http://doi.org/10.1016/j.jcin.2009.10.017.
25. Jensen L.O., Thayssen P., Farkas D.K. et al.: Culprit only or multivessel percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction and multivessel disease. EuroIntervention 2012; 8(4): 456-464. http://doi.org/10.4244/EIJV8I4A72.
26. Di Mario C., Mara S., Flavio A. et al.: Single vs multivessel treatment during primary angioplasty: results of the multicentre randomised HEpacoat for cuLPrit or multivessel stenting for Acute Myocardial Infarction (HELP AMI) Study. Int. J. Cardiovasc. Intervent. 2004; 6(3-4): 128-133. http://doi.org/10.1080/14628840310030441.
27. Politi L., Sgura F., Rossi R. et al.: A randomised trial of target-vessel versus multi-vessel revascularisation in ST-elevation myocardial infarction: major adverse cardiac events during long-term follow-up. Heart 2010; 96(9): 662-667.
28. Wald D.S., Morris J.K., Wald N.J. et al.: Randomized trial of preventive angioplasty in myocardial infarction. N. Engl. J. Med. 2013; 369(12): 1115-1123.
29. Gershlick A.H., Khan J.N., Kelly D.J. et al.: Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial. J. Am. Coll. Cardiol. 2015; 65(10): 963-972.
30. Engstrøm T., Kelbæk H., Helqvist S. et al.: Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3–PRIMULTI): an open-label, randomised controlled trial. Lancet 2015; 386(9994): 665-671.
31. Smits P.C., Abdel-Wahab M., Neumann F.J. et al.: Fractional Flow Reserve-Guided Multivessel Angioplasty in Myocardial Infarction. N. Engl. J. Med. 2017; 376(13): 1234-1244.
32. Ghani A., Dambrink J.H., van ‘t Hof A.W. et al.: Treatment of non-culprit lesions detected during primary PCI: long-term follow-up of a randomised clinical trial. Neth. Heart J. 2012; 20(9): 347-353. http://doi.org/10.1007/s12471-012-0281-y.
33. Lu C., Huang H., Li J. et al.: Complete versus culprit-only revascularization during primary percutaneous coronary intervention in ST-elevation myocardial infarction patients with multivessel disease: a meta-analysis. Kaohsiung J. Med. Sci. 2013; 29(3): 140-149. http://doi.org/10.1016/j.kjms.2012.08.024.
34. Bangalore S., Toklu B., Wetterslev J.: Complete versus culprit-only revascularization for ST-segment-elevation myocardial infarction and multivessel disease. Circ. Cardiovasc. Interv. 2015; 8(4): e002142.
35. Elgendy I.Y., Mahmoud A.N., Kumbhani D.J. et al.: Complete or culprit-only revascularization for patients with multivessel coronary artery disease undergoing percutaneous coronary intervention: a pairwise and network meta-analysis of randomized trials. JACC Cardiovasc. Interv. 2017; 10(4): 315-324.
2. Mortality G.B.D., Causes of Death C.: Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385(9963): 117-171. http://doi.org/10.1016/S0140-6736(14)61682-2.
3. Park D.W., Clare R.M., Schulte P.J. et al.: Extent, location, and clinical significance of non-infarct-related coronary artery disease among patients with ST-elevation myocardial infarction. JAMA 2014; 312(19): 2019-2027. http://doi.org/10.1001/jama.2014.15095.
4. Sorajja P., Gersh B.J., Cox D.A. et al.: Impact of multivessel disease on reperfusion success and clinical outcomes in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. Eur. Heart J. 2007; 28(14): 1709-1716. http://doi.org/10.1093/eurheartj/ehm184.
5. Ibanez B., James S., Agewall S. et al.: 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur. Heart J. 2017. http://doi.org/10.1093/eurheartj/ehx393.
6. Windecker S., Kolh P., Alfonso F. et al.: 2014 ESC/EACTS guidelines on myocardial revascularization. Kardiologia Polska (Polish Heart Journal) 2014; 72(12): 1253-1379.
7. Levine G.N., Bates E.R., Blankenship J.C. et al.: 2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. J. Am. Coll. Cardiol. 2016; 67(10): 1235-1250. http://doi.org/10.1016/j.jacc.2015.10.005.
8. Cavender M.A., Milford-Beland S., Roe M.T. et al.: Prevalence, predictors, and in-hospital outcomes of non-infarct artery intervention during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (from the National Cardiovascular Data Registry). Am. J. Cardiol. 2009; 104(4): 507-513.
9. Jaguszewski M., Radovanovic D., Nallamothu B.K. et al.: Multivessel versus culprit vessel percutaneous coronary intervention in ST-elevation myocardial infarction: is more worse? EuroIntervention 2013; 9(8): 909-915. http://doi.org/10.4244/EIJV9I8A153.
10. Santos A.R., Picarra B.C., Celeiro M. et al.: Multivessel approach in ST-elevation myocardial infarction: impact on in-hospital morbidity and mortality. Rev. Port. Cardiol. 2014; 33(2): 67-73. http://doi.org/10.1016/j.repc.2013.07.015.
11. Dziewierz A., Siudak Z., Rakowski T. et al.: Impact of multivessel coronary artery disease and noninfarct-related artery revascularization on outcome of patients with ST-elevation myocardial infarction transferred for primary percutaneous coronary intervention (from the EUROTRANSFER Registry). Am. J. Cardiol. 2010; 106(3): 342-347.
12. Abe D., Sato A., Hoshi T. et al.: Initial culprit-only versus initial multivessel percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction: results from the Ibaraki Cardiovascular Assessment Study registry. Heart and Vessels 2014; 29(2): 171-177.
13. Iqbal M.B., Ilsley C., Kabir T. et al.: Culprit Vessel Versus Multivessel Intervention at the Time of Primary Percutaneous Coronary Intervention in Patients With ST-Segment – Elevation Myocardial Infarction and Multivessel Disease. Circulation: Cardiovascular Quality and Outcomes 2014; 7(6): 936-943.
14. Braga C.G., Cid-Álvarez A.B., Diéguez A.R. et al.: Multivessel Versus Culprit-only Percutaneous Coronary Intervention in ST-segment Elevation Acute Myocardial Infarction: Analysis of an 8-year Registry. Revista Española de Cardiología (English Edition) 2017; 70(6): 425-432.
15. Corpus R.A., House J.A., Marso S.P. et al.: Multivessel percutaneous coronary intervention in patients with multivessel disease and acute myocardial infarction. Am. Heart J. 2004; 148(3): 493-500. http://doi.org/10.1016/j.ahj.2004.03.051.
16. Kim M.C., Jeong M.H., Park K.H. et al.: Three-year clinical outcomes of staged, ad hoc and culprit-only percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction and multivessel disease. Int. J. Cardiol. 2014; 176(2): 505-507. http://doi.org/10.1016/j.ijcard.2014.07.054.
17. Varani E., Balducelli M., Aquilina M. et al.: Single or multivessel percutaneous coronary intervention in ST-elevation myocardial infarction patients. Catheter Cardiovasc. Interv. 2008; 72(7): 927-933. http://doi.org/10.1002/ccd.21722.
18. Russo J.J., Wells G.A., Chong A.Y. et al.: Safety and Efficacy of Staged Percutaneous Coronary Intervention During Index Admission for ST-Elevation Myocardial Infarction With Multivessel Coronary Disease (Insights from the University of Ottawa Heart Institute STEMI Registry). Am. J. Cardiol. 2015; 116(8): 1157-1162. http://doi.org/10.1016/j.amjcard.2015.07.029.
19. Ma L.X., Lu Z.H., Wang L. et al.: Culprit vessel only versus “one-week” staged percutaneous coronary intervention for multivessel disease in patients presenting with ST-segment elevation myocardial infarction. J. Geriatr. Cardiol. 2015; 12(3): 226-231. http://doi.org/10.11909/j.issn.1671-5411.2015.03.001.
20. Lee H.W., Hong T.J., Yang M.J. et al.: Comparison of infarct-related artery vs multivessel revascularization in ST-segment elevation myocardial infarction with multivessel disease: analysis from Korea Acute Myocardial Infarction Registry. Cardiol. J. 2012; 19(3): 256-266.
21. Chen H.C., Tsai T.H., Fang H.Y. et al.: Benefit of revascularization in non-infarct-related artery in multivessel disease patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Int. Heart J. 2010; 51(5): 319-324.
22. Toyota T., Shiomi H., Taniguchi T. et al.: Culprit Vessel-Only vs. Staged Multivessel Percutaneous Coronary Intervention Strategies in Patients With Multivessel Coronary Artery Disease Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction. Circ. J. 2016; 80(2): 371-378. http://doi.org/10.1253/circj.CJ-15-0493.
23. Manari A., Varani E., Guastaroba P. et al.: Long‐term outcome in patients with ST segment elevation myocardial infarction and multivessel disease treated with culprit‐only, immediate, or staged multivessel percutaneous revascularization strategies: Insights from the REAL registry. Catheter. Cardiovasc. Interv. 2014; 84(6): 912-922.
24. Hannan E.L., Samadashvili Z., Walford G. et al.: Culprit vessel percutaneous coronary intervention versus multivessel and staged percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel disease. JACC Cardiovasc. Interv. 2010; 3(1): 22-31. http://doi.org/10.1016/j.jcin.2009.10.017.
25. Jensen L.O., Thayssen P., Farkas D.K. et al.: Culprit only or multivessel percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction and multivessel disease. EuroIntervention 2012; 8(4): 456-464. http://doi.org/10.4244/EIJV8I4A72.
26. Di Mario C., Mara S., Flavio A. et al.: Single vs multivessel treatment during primary angioplasty: results of the multicentre randomised HEpacoat for cuLPrit or multivessel stenting for Acute Myocardial Infarction (HELP AMI) Study. Int. J. Cardiovasc. Intervent. 2004; 6(3-4): 128-133. http://doi.org/10.1080/14628840310030441.
27. Politi L., Sgura F., Rossi R. et al.: A randomised trial of target-vessel versus multi-vessel revascularisation in ST-elevation myocardial infarction: major adverse cardiac events during long-term follow-up. Heart 2010; 96(9): 662-667.
28. Wald D.S., Morris J.K., Wald N.J. et al.: Randomized trial of preventive angioplasty in myocardial infarction. N. Engl. J. Med. 2013; 369(12): 1115-1123.
29. Gershlick A.H., Khan J.N., Kelly D.J. et al.: Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial. J. Am. Coll. Cardiol. 2015; 65(10): 963-972.
30. Engstrøm T., Kelbæk H., Helqvist S. et al.: Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3–PRIMULTI): an open-label, randomised controlled trial. Lancet 2015; 386(9994): 665-671.
31. Smits P.C., Abdel-Wahab M., Neumann F.J. et al.: Fractional Flow Reserve-Guided Multivessel Angioplasty in Myocardial Infarction. N. Engl. J. Med. 2017; 376(13): 1234-1244.
32. Ghani A., Dambrink J.H., van ‘t Hof A.W. et al.: Treatment of non-culprit lesions detected during primary PCI: long-term follow-up of a randomised clinical trial. Neth. Heart J. 2012; 20(9): 347-353. http://doi.org/10.1007/s12471-012-0281-y.
33. Lu C., Huang H., Li J. et al.: Complete versus culprit-only revascularization during primary percutaneous coronary intervention in ST-elevation myocardial infarction patients with multivessel disease: a meta-analysis. Kaohsiung J. Med. Sci. 2013; 29(3): 140-149. http://doi.org/10.1016/j.kjms.2012.08.024.
34. Bangalore S., Toklu B., Wetterslev J.: Complete versus culprit-only revascularization for ST-segment-elevation myocardial infarction and multivessel disease. Circ. Cardiovasc. Interv. 2015; 8(4): e002142.
35. Elgendy I.Y., Mahmoud A.N., Kumbhani D.J. et al.: Complete or culprit-only revascularization for patients with multivessel coronary artery disease undergoing percutaneous coronary intervention: a pairwise and network meta-analysis of randomized trials. JACC Cardiovasc. Interv. 2017; 10(4): 315-324.