Completing the job: The advantage of complete revascularization in ST-elevation myocardial infarction over culprit-only revascularization strategies

摘要

Multiple mechanisms have been advocated to explain why a more widespread atherosclerotic involvement of the coronary arteries reduces survival in STEMI patients. First, subjects with multivessel disease tend to have a higher burden of comorbidities. Second, the extent of epicardial CAD might be a marker of microvascular disease which may directly impact on reperfusion (and prognosis) following STEMI. Third, obstructive stenoses in non-culprit vessels directly cause myocardial ischemia [2]. Fourth, atherosclerotic non-culprit plaques may harbor features of vulner- ability which associate with recurrent atherothrombosis [3].