INTRODUCTION
Ischaemic heart disease is the most cause of death in all over the world. When Andreas Gruentzig performed PTCA in human, we have also opened the interventional era which significantly decrease the death cause by Cardial Vascular Disease, especially in Acute Myocardial Infartion.
Over 30 years, the ratio of patient admitted to the hospital for myocardial Infarction dramatically decrease from 46,086 to 18,691 per year in 2008 . With the same trend, the proportion ST – segment elevation myocardical infarction (STEMI) also decline but the 30-day mortality after STEMI have no significant change [1]
In addition, Sorajja et al reported that the proportion of Multivessel Coronary Disease in all the patient with ST segment Elevation Myocardial Infarction (STEMI) about 40 – 50% and the incidence of Major Adverse Cardiac Event (MACE) is 14.5 %, 19.5% and 23.6% with single-vessel, two- vessel and three-vessel, respectively [2]. Thus, the more stenosed vessel, the more mortality and another major adverse cardiac events. …show more content…
The guideline of ESC also cautiously stated that “The best strategy for STEMI patients with multi-vessel disease, who underwent primary PCI of the infarct-related artery in the acute phase with remaining multivessel disease, is still not well established” [4].
In spite of many observational and interventional study, surprisingly, the data from some RCTs study inverse to another observational study [5]. The clinical benefit of complete revascularization still controversial. That is the reason we want to debate this issue to answer the question: “Which complete or culprit-only revascularization will better than the
Ischaemic heart disease is the most cause of death in all over the world. When Andreas Gruentzig performed PTCA in human, we have also opened the interventional era which significantly decrease the death cause by Cardial Vascular Disease, especially in Acute Myocardial Infartion.
Over 30 years, the ratio of patient admitted to the hospital for myocardial Infarction dramatically decrease from 46,086 to 18,691 per year in 2008 . With the same trend, the proportion ST – segment elevation myocardical infarction (STEMI) also decline but the 30-day mortality after STEMI have no significant change [1]
In addition, Sorajja et al reported that the proportion of Multivessel Coronary Disease in all the patient with ST segment Elevation Myocardial Infarction (STEMI) about 40 – 50% and the incidence of Major Adverse Cardiac Event (MACE) is 14.5 %, 19.5% and 23.6% with single-vessel, two- vessel and three-vessel, respectively [2]. Thus, the more stenosed vessel, the more mortality and another major adverse cardiac events. …show more content…
The guideline of ESC also cautiously stated that “The best strategy for STEMI patients with multi-vessel disease, who underwent primary PCI of the infarct-related artery in the acute phase with remaining multivessel disease, is still not well established” [4].
In spite of many observational and interventional study, surprisingly, the data from some RCTs study inverse to another observational study [5]. The clinical benefit of complete revascularization still controversial. That is the reason we want to debate this issue to answer the question: “Which complete or culprit-only revascularization will better than the