Invasive and Non-invasive Assessment of Non-culprit Coronary Lesions in Patients with ST-segment Elevation Myocardial Infarction

TL;DR

This paper reviews how to assess non-culprit coronary lesions in heart attack patients to guide treatment decisions.

Contribution

It provides a summary of current techniques for managing multivessel disease in STEMI patients.

Findings

Multivessel disease increases the risk of recurring heart issues in STEMI patients.

Complete revascularization is recommended for significant non-culprit lesions.

Optimal timing and methods for assessing non-culprit lesions remain unclear.

Abstract

The angiographic evidence of coronary multivessel disease (MVD) increases significantly the risk of recurrent ischemic events in patients with ST-segment elevation myocardial infarction (STEMI).

Recent evidence suggests that a complete revascularization strategy should be considered the standard of care in these patients and performed for significant non-culprit lesions (NCLs) after careful assessment of the individual risk-benefit ratio. However, the optimal timing and the modality for the assessment of NCLs is not fully standardized.

This brief review aims to summarise the management of MVD in patients with STEMI and to provide an overview of the principal techniques used to guide revascularisation in this high-risk clinical setting.