Management of Non-Culprit Lesions in STEMI Patients with Multivessel Disease

Piccolo, Raffaele; Manzi, Lina; Simonetti, Fiorenzo; Leone, Attilio; Angellotti, Domenico; Molaro, Maddalena Immobile; Verde, Nunzia; Cirillo, Plinio; Serafino, Luigi Di; Franzone, Anna; Spaccarotella, Carmen; Esposito, Giovanni

doi:10.3390/jcm12072572

JCM

2023

DOI: 10.3390/jcm12072572

|View full text |Cite

Management of Non-Culprit Lesions in STEMI Patients with Multivessel Disease

Raffaele Piccolo

Lina Manzi

Fiorenzo Simonetti

et al.

Abstract: Multivessel disease is observed in approximately 50% of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Data from randomized clinical trials has shown that complete revascularization in the STEMI setting improves clinical outcomes by reducing the risk of reinfarction and urgent revascularization. However, the timing and modality of revascularization of non-culprit lesions are still debated. PCI of non-culprit lesions can be performed… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2024

Publication Types

Select...

Article3

Relationship

Self Cite0

Independent3

Authors

Journals

Cited by 3 publications

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Diagnostic Performance of Quantitative Flow Ratio for the Assessment of Non‐Culprit Lesions in Myocardial Infarction (QFR‐OUTSMART): Systematic Review and Meta‐Analysis

Salinas‐Casanova,

Jiménez‐Franco,

Jerjes‐Sanchez

et al. 2024

Cathet Cardio Intervent

View full text Add to dashboard Cite

BackgroundQuantitative flow ratio (QFR) analysis is a simple and non‐invasive coronary physiological assessment method with evidence for evaluating stable coronary artery disease with correlation to fractional flow reserve (FFR). However, there is no evidence to recommend its use in non‐culprit lesions (NCLs) in myocardial infarction (MI).MethodsWe performed a systematic review and meta‐analysis using the PRISMA and PROSPERO statements. The study's primary objective was to assess the diagnostic accuracy of QFR in identifying functionally significant NCLs after MI based on invasive FFR and non‐hyperemic pressure ratios as references. We obtained values of the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). We performed a leave‐one‐out sensitivity analysis for each study's impact on the overall effect.ResultsWe included eight studies, with 713 patients and 920 vessels evaluated with QFR. The overall AUC was 0.941 (I2 = 0.559, p < 0.002), with a sensitivity of 87.3%, a specificity of 89.4%, a PPV of 86.6%, and an NPV of 90.1%. Compared to FFR, we found an AUC of 0.957 (I2 = 0.331, p < 0.194), a sensitivity of 89.6%, a specificity of 89.8%, a PPV of 88.3%, and an NPV of 91%. The sensitivity analysis showed a similar diagnostic performance in both studies.ConclusionsQFR is effective in analyzing NCLs with a significant diagnostic yield compared to FFR, with an excellent AUC in MI patients. Performing prospective multicenter studies to characterize this population and reproduce our results is essential.

show abstract

Diagnostic Performance of Quantitative Flow Ratio for the Assessment of Non‐Culprit Lesions in Myocardial Infarction (QFR‐OUTSMART): Systematic Review and Meta‐Analysis

Salinas‐Casanova,

Jiménez‐Franco,

Jerjes‐Sanchez

et al. 2024

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

Case report: acute myocarditis in two patients with coronary artery disease presenting with chest pain—thinking outside the box

Amelotti,

Brusamolino,

Mapelli

et al. 2024

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background In a subset of patients, acute myocarditis (AM) may mimic acute myocardial infarction, with a similar clinical presentation characterized by chest pain, electrocardiogram changes consistent with acute coronary syndromes (ACS), and serum markers increment. Case Summary We present two cases of infarct-like myocarditis in patients with known coronary artery disease (CAD), in which the discrepancy between trans-thoracic echocardiogram findings, ECG and angiography prompted us to look beyond the simplest diagnosis. In these cases, making a prompt and correct diagnosis is pivotal to address adequate therapy and establish a correct prognosis. Discussion The right diagnosis can avoid unnecessary coronary revascularizations and subsequent antiplatelet therapy that may be associated with an increased hemorrhagic risk. Moreover, it allows setting up guideline-directed therapy for myocarditis, proper follow-up, as well as recommending abstention from physical activity.

show abstract

Review of Advancements in Managing Cardiogenic Shock: From Emergency Care Protocols to Long-Term Therapeutic Strategies

Martínez León,

Bazal Chacón,

Herrador Galindo

et al. 2024

JCM

View full text Add to dashboard Cite

Cardiogenic shock (CS) is a complex multifactorial clinical syndrome of end-organ hypoperfusion that could be associated with multisystem organ failure, presenting a diverse range of causes and symptoms. Despite improving survival in recent years due to new advancements, CS still carries a high risk of severe morbidity and mortality. Recent research has focused on improving early detection and understanding of CS through standardized team approaches, detailed hemodynamic assessment, and selective use of temporary mechanical circulatory support devices, leading to better patient outcomes. This review examines CS pathophysiology, emerging classifications, current drug and device therapies, standardized team management strategies, and regionalized care systems aimed at optimizing shock outcomes. Furthermore, we identify gaps in knowledge and outline future research needs.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Management of Non-Culprit Lesions in STEMI Patients with Multivessel Disease

Cited by 3 publications

References 60 publications

Diagnostic Performance of Quantitative Flow Ratio for the Assessment of Non‐Culprit Lesions in Myocardial Infarction (QFR‐OUTSMART): Systematic Review and Meta‐Analysis

Diagnostic Performance of Quantitative Flow Ratio for the Assessment of Non‐Culprit Lesions in Myocardial Infarction (QFR‐OUTSMART): Systematic Review and Meta‐Analysis

Case report: acute myocarditis in two patients with coronary artery disease presenting with chest pain—thinking outside the box

Review of Advancements in Managing Cardiogenic Shock: From Emergency Care Protocols to Long-Term Therapeutic Strategies

Contact Info

Product

Resources

About