Fine-tuning treatment for patients with ST-elevation myocardial infarction

Feng Qian, Edward L. Hannan


As the most severe type of heart attack, ST-elevation myocardial infarction (STEMI) is a life-threatening medical emergency and calls for a rapid response. In the United States, it is estimated that 30% of patients with myocardial infarction have STEMI and that 50% of STEMI patients have multivessel disease (1,2). Literature suggests that compared with STEMI patients with single vessel disease, STEMI patients with multivessel disease have worse clinical outcomes (3). The optimal strategy for the treatment of patients with STEMI and multivessel disease is of increasing interest and practice guidelines continue to evolve with new data (4). Also, the safety and effectiveness of adjunctive aspiration thrombectomy in percutaneous coronary intervention (PCI) are in doubt although it was initially perceived to be an effective therapy to reduce distal embolization (5-7).