Recommendation ID
CG167/4
Question
Culprit vessel primary PCI versus multivessel PCI:- Does multivessel PCI, at the time of presentation of people with acute STEMI, confer an advantage over a strategy of 'culprit vessel only' primary PCI, followed by further elective revascularisation driven by symptoms and evidence of ischaemia?
Any explanatory notes
(if applicable)
Why this is important:- One-third of people presenting with STEMI have multivessel coronary artery disease at the time of presentation. Currently, there is uncertainty about whether to initially treat only the vessel likely to have caused the presentation or whether to treat all significant lesions. Most of the current evidence that examines 'culprit vessel only' primary PCI versus multivessel PCI in these people comes from studies that are underpowered or non-randomised. Answering this question would clarify the appropriate revascularisation strategy for this patient group. A randomised controlled trial powered to examine all-cause mortality and major adverse cardiovascular events with a 5-year follow-up would be the optimum design.

Source guidance details

Comes from guidance
Myocardial infarction with ST-segment elevation: acute management
Number
CG167
Date issued
July 2013

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/07/2013