Firm evidence of complete revascularization with culprit and target vessel revascularization only after ST-segment elevation myocardial infarction

We read with great interest the recently published article written by Anantha Narayanan et al. (1) entitled ‘What is the optimal approach to a non-culprit stenosis after ST-elevation myocardial infarction - Conservative therapy or upfront revascularization? An updated meta-analysis of randomized trials’. Non-culprit percutaneous coronary intervention during a ST-segment elevation myocardial infarction (STEMI) is still controversial. Anantha Narayanan et al. (1) performed a meta-analysis of randomized controlled trials comparing a strategy of complete revascularization (CR) with culprit and target vessel revascularization (TVR)-only after SETMI in patients with multi-vessel disease. The authors found concluded that CR strategy in STEMI patients with multi-vessel disease is associated with reduction in major adverse cardiac events (MACE), cardiac mortality and need for repeat revascularization but with no decrease in the risk of subsequent myocardial infarction or all-cause mortality