INTRODUCTION
Coronary artery disease (CAD) affects over 18 million people in the United States, with over 8.4 million cases present as acute myocardial infarctions.[1] Half of acute myocardial infarctions (AMI) are associated with multivessel disease.[2] Data suggest better outcomes with complete percutaneous revascularization (PR) vs culprit-only PR in the setting of multivessel AMI mainly driven by less need for future urgent revascularization.[2,3] Incomplete PR in patients with multivessel CAD, has been recognized as an independent predictor of mortality [4,5]. On the other hand, surgical revascularization (SR) is the preferred strategy over PR in stable coronary disease when there is complex anatomy, diabetes, and/or left ventricular dysfunction [6–10]. Moreover, SR allows for more complete revascularization than PR and less need for future revascularization.[7][11]
Some studies have shown PR to be associated with lower rates of early stroke than SR, and is known globally to be more widely available.[8] PR can achieve revascularization of the culprit vessel in a more timely manner which is of particular importance in the setting of AMI.[12–15] There are limited data comparing the two revascularization strategies in the setting of AMI given to pros and cons of each strategy.