Does the evidence really suggest that we should completely revascularise bystander disease in patients with ST elevation myocardial infarction undergoing primary angioplasty? Why we still need more definitive trial data to change routine practice
Does the evidence really suggest that we should completely revascularise bystander disease in patients with ST elevation myocardial infarction undergoing primary angioplasty? Why we still need more definitive trial data to change routine practice
Introduction: There remains considerable heterogeneity in the management of significant lesions in non culprit coronary arteries in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Three recent randomised trials have shown clinical outcome benefit in a complete revascularisation approach when compared to PPCI of the culprit artery alone. By contrast, observational data suggest that an aggressive complete revascularisation may not confer clinical benefit and may, in some cases, be harmful.
Areas covered: In this review we discuss the three recent randomised trials that have advocated a complete revasculariation approach in addition to data available from registries.
Expert commentary: An adequately powered, randomised controlled trial is required to answer the question of whether complete revascularisation in STEMI patients is beneficial and, if so, whether it should be ischaemia directed and whether it should be at the index procedure or staged.
75-81
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Curzen, Nicholas
70f3ea49-51b1-418f-8e56-8210aef1abf4
13 January 2017
Mahmoudi, Michael
f6a55246-399e-4f81-944e-a4b169786e8a
Curzen, Nicholas
70f3ea49-51b1-418f-8e56-8210aef1abf4
Mahmoudi, Michael and Curzen, Nicholas
(2017)
Does the evidence really suggest that we should completely revascularise bystander disease in patients with ST elevation myocardial infarction undergoing primary angioplasty? Why we still need more definitive trial data to change routine practice.
Expert Review of Cardiovascular Therapy, 15 (2), .
(doi:10.1080/14779072.2017.1273770).
Abstract
Introduction: There remains considerable heterogeneity in the management of significant lesions in non culprit coronary arteries in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Three recent randomised trials have shown clinical outcome benefit in a complete revascularisation approach when compared to PPCI of the culprit artery alone. By contrast, observational data suggest that an aggressive complete revascularisation may not confer clinical benefit and may, in some cases, be harmful.
Areas covered: In this review we discuss the three recent randomised trials that have advocated a complete revasculariation approach in addition to data available from registries.
Expert commentary: An adequately powered, randomised controlled trial is required to answer the question of whether complete revascularisation in STEMI patients is beneficial and, if so, whether it should be ischaemia directed and whether it should be at the index procedure or staged.
Text
Does the evidence really suggestthat we should completely revascularise bystander disease in patients withST elevation myocardial infarction
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Accepted/In Press date: 16 December 2016
e-pub ahead of print date: 27 December 2016
Published date: 13 January 2017
Organisations:
Human Development & Health
Identifiers
Local EPrints ID: 410536
URI: http://eprints.soton.ac.uk/id/eprint/410536
ISSN: 1477-9072
PURE UUID: 6a90145d-e954-4998-99be-176bb8f0ca65
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Date deposited: 09 Jun 2017 09:03
Last modified: 16 Mar 2024 04:24
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