医学
血运重建
心脏病学
心源性休克
心肌梗塞
内科学
急性冠脉综合征
经皮
经皮冠状动脉介入治疗
介入心脏病学
冠状动脉疾病
临床试验
作者
Denise Cristiana Faro,Claudio Laudani,Federica Agnello,Nicola Ammirabile,Simone Finocchiaro,Marco Legnazzi,Maria Sara Mauro,Placido Maria Mazzone,Giovanni Occhipinti,Carla Rochira,Lorenzo Scalia,Marco Spagnolo,Antonio Greco,Davide Capodanno
标识
DOI:10.1016/j.jcin.2023.07.043
摘要
Multivessel disease (MVD) affects approximately 50% of patients with acute coronary syndromes (ACS) and is significantly burdened by poor outcomes and high mortality. It represents a clinical challenge in patient management and decision making and subtends an evolving research area related to the pathophysiology of unstable plaques and local or systemic inflammation. The benefits of complete revascularization are established in hemodynamically stable ACS patients with MVD, and guidelines provide some reference points to inform clinical practice, based on an evidence level that is solid for ST-segment elevation myocardial infarction and less robust for non–ST-segment elevation myocardial infarction and cardiogenic shock. However, several areas of uncertainty remain, such as the optimal timing for complete revascularization or the best guiding strategy for intermediate stenoses. We performed a systematic review of current evidence in the field of percutaneous revascularization in ACS and MVD, also including future perspectives from ongoing trials that will directly compare different timing strategies and investigate the role of invasive and noninvasive guidance techniques. (Complete percutaneous coronary revascularization in patients with acute myocardial infarction and multivessel disease; CRD42022383123)
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