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Coronary Intervention in Patients With Acute Coronary Syndrome: Does Every Culprit Lesion Require Revascularization?

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Abstract

In patients presenting with acute coronary syndromes, 30–60% of patients have multiple significant coronary lesions. Patients presenting with acute coronary syndrome and multivessel disease have a significant increase in the incidence of major cardiovascular morbidity and mortality when compared with patients who have single-vessel disease. Although great progress has been made to reduce the extent of infarction through effective and rapid reperfusion due to faster time to reperfusion, potent antiplatelets, and antithrombotics, there is not much consensus as to how best to treat multivessel disease in patients presenting with acute coronary syndromes. We present a review of the current body of evidence for safety and efficacy of multivessel revascularization in patients presenting with acute coronary syndromes.

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Abbreviations

BARI:

Bypass Angioplasty Revascularization Investigation

CASS:

Coronary Artery Surgery Study

FUTURA/OASIS 8:

Fondaparinux Trial With UFH During Revascularization in Acute Coronary Syndromes

HELP AMI:

Hepacoat for Culprit or Multivessel Stenting for Acute Myocardial Infarction

PROSPECT:

Providing Regional Observations to Study Predictors of Events in the Coronary Tree

TAMI:

Thrombolysis and Angioplasty in Myocardial Infarction

TACTICS-TIMI 18:

Treat Angina With Aggrastat and Determine Cost of Therapy With an Invasive or Conservative Strategy

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Disclosure

Dr. David P. Faxon is on the advisory board for Johnson & Johnson, and has stock options in RIVA medical. No other potential conflicts of interest relevant to this article were reported.

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  1. Division of Cardiology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, 0BC3–Room 012P, 1620 Tremont Street, Boston, MA, 02120, USA

    Sripal Bangalore & David P. Faxon

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  1. Sripal Bangalore
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  2. David P. Faxon
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Correspondence to David P. Faxon.

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Bangalore, S., Faxon, D.P. Coronary Intervention in Patients With Acute Coronary Syndrome: Does Every Culprit Lesion Require Revascularization?. Curr Cardiol Rep 12, 330–337 (2010). https://doi.org/10.1007/s11886-010-0115-8

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