Timing Is Everything — Evidence for When to Perform Complete Revascularization in STEMI

The performance of complete revascularization in patients with multivessel coronary artery disease and ST-segment elevation myocardial infarction (STEMI) has been a topic of debate. This scenario is extremely common, given that multivessel coronary artery disease is detected during index coronary angiography in approximately 50% of patients with STEMI.¹ Although current guidelines from the American College of Cardiology and American Heart Association consider staged percutaneous coronary intervention (PCI) a class I indication for non-infarct-related artery stenosis,² during the previous 10 years extreme uncertainty existed about whether any non-infarct-related lesions should be revascularized, including lesions present in patients with concomitant cardiogenic shock. …