How Should We Treat Myocardial Infarction Patients With Multivessel Disease? - Staged Revascularization? Or Stent Them All Acutely?

In this issue of the Journal, Toyota et al5 report that a staged PCI strategy for angiographically significant nonculprit lesions arly reperfusion of the occluded infarct-related artery (IRA) using primary percutaneous coronary intervention (PCI) has been the primary goal of treatment for patients with acute ST-segment elevation myocardial infarction (STEMI).1 Concomitant atherosclerosis in coronary arteries other than the IRA has been reported to be observed in 40–50% of patients with acute MI (AMI).2 In addition, STEMI patients with multivessel disease (MVD) are at increased risk of major adverse cardiac events following primary PCI.2 Although most interventional cardiologists believe that complete revascularization of ischemia-producing nonculprit E