Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013;9(2):136-45.
doi: 10.5114/pwki.2013.35448. Epub 2013 Jun 17.

Percutaneous coronary intervention in treatment of multivessel coronary artery disease in patients with non-ST-segment elevation acute coronary syndrome

Paweł Gąsior  1 , Piotr Desperak  1 , Karolina Gierlaszyńska  2 , Michał Hawranek  2 , Marek Gierlotka  2 , Mariusz Gąsior  2 , Lech Poloński  2
Affiliations
Review

Percutaneous coronary intervention in treatment of multivessel coronary artery disease in patients with non-ST-segment elevation acute coronary syndrome

Paweł Gąsior et al. Postepy Kardiol Interwencyjnej. 2013.

Abstract

Among patients with non-ST-elevated acute coronary syndromes (NSTE-ACS) the estimated percentage of single vessel coronary artery disease (SV-CAD) observed during coronarography is about 20-40%, while multivessel coronary artery disease (MV-CAD) is found in about 40-60%. Further treatment in patients with both SV CAD and MV CAD is usually culprit vessel percutaneous coronary intervention (CV-PCI). Nevertheless, in the group of patients with MV-CAD there is still a problematic decision whether the non-infarct related arteries (non-IRA) should be treated with PCI. According to the European Society of Cardiology (ESC) guidelines on myocardial revascularization this decision should be based on the overall clinical and angiographic status of the patient; simultaneously they suggest performing ad hoc CV-PCI. The decision of performing intervention in the rest of the narrowed coronary arteries should be made after consultation with the heart team or according to the protocols adopted in the specific clinic. Furthermore, there is a question of whether the procedure should be performed immediately after culprit vessel revascularization or it should be postponed until the patient is stabilized. Due to the lack of specific recommendations we decided to perform an analysis of existing studies which compared culprit versus multivessel revascularization in patients with MV-CAD and non-ST-elevated acute coronary syndromes.

Keywords: multivessel coronary artery disease; non-ST-elevated acute coronary syndrome; percutaneous coronary intervention.

PubMed Disclaimer

References

    1. Yeh RW, Sidney S, Chandra M, et al. Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med. 2010;362:2155–2165. - PubMed
    1. Gierlotka M, Gasior M, Wilczek K, et al. Temporal Trends in the Treatment and Outcomes of Patients With Non-ST-Segment Elevation Myocardial Infarction in Poland from 2004-2010 (from the Polish Registry of Acute Coronary Syndromes) Am J Cardiol. 2012;109:779–786. - PubMed
    1. Yan AT, Yan RT, Tan M, et al. In-hospital revascularization and one-year outcome of acute coronary syndrome patients stratified by the GRACE risk score. Am J Cardiol. 2005;96:913–916. - PubMed
    1. Mehta SR, Granger CB, Boden WE, et al. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med. 2009;360:2165–2175. - PubMed
    1. Sorajja P, Gersh BJ, Cox DA, et al. Impact of delay to angioplasty in patients with acute coronary syndromes undergoing invasive management: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial. J Am Coll Cardiol. 2010;55:1416–1424. - PubMed

LinkOut - more resources