Culprit Vessel–Only Intervention Better Than Multivessel Intervention for Acute MI

Observational data and meta-analysis results support current recommendations to treat only infarct-related lesions during primary percutaneous coronary intervention.

Many patients with acute myocardial infarction (MI) have multivessel disease. Despite a lack of evidence from large, randomized studies, current guidelines for treating ST-segment-elevation MI (STEMI) in hemodynamically stable patients recommend percutaneous coronary intervention (PCI) in the culprit vessel only (with later staged PCI of other lesions) rather than multivessel PCI (in all significant lesions) during the initial procedure. In an analysis of observational data from the HORIZONS-AMI trial, investigators compared outcomes of single-procedure multivessel PCI in 275 patients with those of staged procedures in 393 patients (median time between procedures, 30 days).

The two groups had similar clinical features. However, the single-pr…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI