Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete—Ad Hoc or Staged

Shalin Patel, Steven R. Bailey

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Purpose of Review: This review will address the clinical conundrum of those who may derive clinical benefit from complete revascularization of coronary stenosis that are discovered at the time of ST segment elevation myocardial infarction (STEMI). The decision to revascularize additional vessels with angiographic stenosis beyond the culprit lesion remains controversial, as does the timing of revascularization. Recent Findings: STEMI patients represent a high-risk patient population that have up to a 50% prevalence of multivessel disease. Multivessel disease represents an important risk factor for short- and long-term morbidity and mortality. Potential benefits of multivessel PCI for STEMI might include reduced short- and long-term mortality, revascularization, reduced resource utilization, and costs. Which population will benefit and what the optimal timing of revascularization in the peri-MI period remains controversial. Summary: Consideration of multivessel revascularization in the setting of STEMI may occur in up to one half of STEMI patients. Evaluation of the comorbidities including diabetes, extent of myocardium at risk, lesion complexity, ventricular function, and risk factors for complications such as contrast induced nephropathy which is important in determining the appropriate care pathway.

Original languageEnglish (US)
Article number93
JournalCurrent Cardiology Reports
Issue number10
StatePublished - Oct 1 2017


  • CABG
  • Complete revascularization
  • Diabetes
  • FFR
  • Multivessel disease
  • PCI
  • Physiologic assessment
  • Primary percutaneous coronary intervention
  • ST segment elevation myocardial infarction (STEMI)
  • Single vessel
  • Staged

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete—Ad Hoc or Staged'. Together they form a unique fingerprint.

Cite this