Kim Min Chul, Jeong Myung Ho, Kim Sang Hyung, Hong Young Joon, Kim Ju Han, Ahn Youngkeun
Department of Cardiovascular Medicine, Heart Center, Chonnam National University Hospital, Gwangju, Korea.
Korean Circ J. 2014 May;44(3):131-8. doi: 10.4070/kcj.2014.44.3.131.
Primary percutaneous coronary intervention (PCI) is a standard interventional treatment modality for ST-segment elevation myocardial infarction (STEMI). Diagnostic coronary angiogram during PCI reveals multivessel coronary artery disease in about half of patients with STEMI, and it is difficult to make decision on the extent of intervention in these patients. Although revascularization for the infarct-related artery only is still effective for STEMI patients, several studies have reported the efficacy of multivessel revascularization during primary PCI, as well as in a staged PCI procedure. Clinicians should consider clinical aspects such as initial cardiogenic shock and myocardial viability when performing primary multivessel intervention, including the risks and benefits of multivessel revascularization in patients undergoing primary PCI. This review describes the current status of performing multivessel PCI in patients with STEMI and proposes an optimal revascularization strategy based on the previous literature.
直接经皮冠状动脉介入治疗（PCI）是ST段抬高型心肌梗死（STEMI）的标准介入治疗方式。PCI期间的诊断性冠状动脉造影显示，约半数STEMI患者存在多支冠状动脉疾病，对这些患者的干预范围难以做出决策。尽管仅对梗死相关动脉进行血运重建对STEMI患者仍有效，但多项研究报告了直接PCI期间以及分期PCI手术中多支血管血运重建的疗效。临床医生在进行直接多支血管干预时，应考虑初始心源性休克和心肌存活性等临床因素，包括直接PCI患者多支血管血运重建的风险和益处。本综述描述了STEMI患者进行多支血管PCI的现状，并根据既往文献提出了最佳血运重建策略。
