2021 ACC/AHA/SCAI Coronary Artery Revascularization Guidelines for Managing the Nonculprit Artery in STEMI

Creighton W Don; Brittany A Zwischenberger; Paul A Kurlansky; Sunil V Rao; Garima Sharma; Jennifer S Lawton; Jacqueline E Tamis-Holland

doi:10.1016/j.jaccas.2022.02.003

2021 ACC/AHA/SCAI Coronary Artery Revascularization Guidelines for Managing the Nonculprit Artery in STEMI

JACC Case Rep. 2022 Apr 6;4(7):377-384. doi: 10.1016/j.jaccas.2022.02.003.

Authors

Creighton W Don¹, Brittany A Zwischenberger², Paul A Kurlansky³, Sunil V Rao⁴, Garima Sharma⁵, Jennifer S Lawton⁶, Jacqueline E Tamis-Holland⁷

Affiliations

¹ Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington, USA.
² Division of Cardiothoracic Surgery, Duke University, Durham, North Carolina, USA.
³ Division of Cardiac Surgery, Columbia University, New York, New York, USA.
⁴ Department of Medicine, Division of Cardiology, Duke University, Durham, North Carolina, USA.
⁵ Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland USA.
⁶ Department of Surgery, Division of Cardiac Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
⁷ Mount Morningside Hospital and the Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Abstract

The 2021 Coronary Artery Disease revascularization guidelines of the American College of Cardiology (ACC), the American Heart Association (AHA), and the Society for Cardiovascular Angiography and Interventions (SCAI) provide recommendations for managing nonculprit arteries in ST-segment elevation myocardial infarction (STEMI). Although staged revascularization is preferred, at times same-setting intervention, coronary artery bypass surgery, or medical therapy may be preferable. These cases exemplify clinical scenarios for treating nonculprit arteries in STEMI. (Level of Difficulty: Intermediate.).

Keywords: CABG, coronary artery bypass grafting; LAD, left anterior descending; LOE, level of evidence; OM, obtuse marginal; PCI, percutaneous coronary intervention; RCA, right coronary artery; ST-segment elevation myocardial infarction; STEMI; STEMI, ST-segment elevation myocardial infarction; complete revascularization; multivessel; myocardial infarction; nonculprit; noninfarct; percutaneous coronary intervention; surgery.

Publication types

Case Reports