Piccolo Raffaele, Manzi Lina, Simonetti Fiorenzo, Leone Attilio, Angellotti Domenico, Immobile Molaro Maddalena, Verde Nicola, Cirillo Plinio, Di Serafino Luigi, Franzone Anna, Spaccarotella Carmen Anna Maria, Esposito Giovanni
Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy.
J Clin Med. 2023 Mar 29;12(7):2572. doi: 10.3390/jcm12072572.
Multivessel disease is observed in approximately 50% of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Data from randomized clinical trials has shown that complete revascularization in the STEMI setting improves clinical outcomes by reducing the risk of reinfarction and urgent revascularization. However, the timing and modality of revascularization of non-culprit lesions are still debated. PCI of non-culprit lesions can be performed during the index primary PCI or as a staged procedure and can be guided by angiography, functional assessment, or intracoronary imaging. In this review, we summarize the available evidence about the management of non-culprit lesions in STEMI patients with or without cardiogenic shock.
在接受直接经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者中，约50%观察到多支血管病变。随机临床试验的数据表明，在STEMI情况下进行完全血运重建可通过降低再梗死和紧急血运重建的风险来改善临床结局。然而，非罪犯病变血运重建的时机和方式仍存在争议。非罪犯病变的PCI可在初次PCI时进行，也可作为分期手术进行，可通过血管造影、功能评估或冠状动脉内成像来指导。在本综述中，我们总结了有关伴或不伴有心源性休克的STEMI患者中非罪犯病变管理的现有证据。
