Bigarren mailako lesioen birbaskularizazioa ST segmentuaren igoera duen sindrome koronario akutuan

ST segmentuaren igoera duen sindrome koronario akutuan (STIMIA) arteria errudunaren angioplastia (AKTP) primarioa aukerako estrategia bihurtu da. Testuinguru honetan AKTP primarioa jasaten duten pazienteen % 40-65ek arteria koronario anitzen gaixotasuna (HAG) du. Ez dago argi zer egin, pazientea hemodinamikoki egonkor egonda, arteria ez errudunekin. Entsegu kliniko berriek birbaskularizazioa osatzearen aldeko datuak agerian utzi dituzte. Berrikuspen honetan STIMIA eta HAG duten pazienteen maneiuaren inguruan dagoen ebidentzia zientifikoa laburbiltzen da. Gako-hitzak: ST igoera duen miokardioko infartu akutua; hodi anitzeko gaixotasuna; arteria ez erruduna; interbentzio koronario perkutaneoa. Percutaneous coronary intervention (PCI) of the culprit lesion is now considered the gold standard in the treatment for patients with ST-segment elevation myocardial infarction (STEMI). Multivessel coronary artery disease (MVD) is found in approximately 40-65% of patients with STEMI undergoing primary PCI. The optimal reperfusion strategy and timing of revascularization (MV-PCI, S-PCI or IRA-PCI) in hemodynamically stable patients with STEMI and multivessel disease remains uncertain. Recent studies suggest that complete revascularization is superior to culprit-only revascularization in this context. In this review we summarize the available evidence on treatment options for patients with STEMI and MVD. Keywords: ST-segment elevation myocardial infarction; multivessel disease; non-infarct related artery; percutaneous coronary intervention.