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.