Complete Revascularization in Acute and Chronic Coronary Syndrome

Abstract

In patients with multivessel disease, complete revascularization (CR) is the most biologically plausible approach irrespective of definition or type or clinical setting (acute or chronic coronary syndrome [ACS or CCS]). It aims at minimizing residual ischemia, relieving symptoms and reducing the risk of future cardiovascular events. Large evidence supports CR benefits in ACS, predominantly ST-segment elevation myocardial infarction, except cardiogenic shock, although optimal assessment and timing remain debated. In patients with CCS, when revascularization is indicated, a functional CR should be attempted. Therefore, heart-team is crucial in selecting the ideal strategy for each patient to optimize decision-making.

Keywords: Acute coronary syndrome (ACS); Chronic coronary syndrome (CCS); Complete revascularization (CR); Coronary artery bypass graft (CABG); Culprit-only revascularization; Incomplete revascularization (IR); Multivessel coronary artery disease (MVD); Percutaneous coronary intervention (PCI).