eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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2/2013
vol. 9
 
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abstract:

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

Paweł Gąsior
,
Piotr Desperak
,
Karolina Gierlaszyńska
,
Michał Hawranek
,
Marek Gierlotka
,
Mariusz Gąsior
,
Lech Poloński

Postep Kardiol Inter 2013; 9, 2 (32): 136–145
DOI: https://doi.org/10.5114/pwki.2013.35448
Online publish date: 2013/06/17
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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:

non-ST-elevated acute coronary syndrome, multivessel coronary artery disease, percutaneous coronary intervention
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