Long-Term Outcomes of Multivessel PCI in Acute Coronary Syndrome: A Systematic Review of Clinical Effectiveness, Safety, and Prognostic Implications

doi:N/A

Bangaldesh Journal of Cardivascular Medicine

2024, Volume 2, Issue 1 : 1-8

Research Article

Long-Term Outcomes of Multivessel PCI in Acute Coronary Syndrome: A Systematic Review of Clinical Effectiveness, Safety, and Prognostic Implications

Jonathan R. Mitchell

Sophia A. Rahman

Michael T. Edwards

Department of Cardiology, Global Medical Research Institute, London, United Kingdom

Division of Interventional Cardiology, International Heart Sciences University, Dubai, UAE

Department of Cardiovascular Medicine, European Clinical Research Center, Berlin, Germany

Abstract

Background

Acute Coronary Syndrome (ACS) remains one of the leading causes of morbidity and mortality worldwide. Approximately 40–60% of ACS patients present with multivessel coronary artery disease (MVD). Percutaneous Coronary Intervention (PCI) has become the standard revascularization strategy in ACS; however, the optimal management of non-culprit lesions remains controversial. Recent evidence suggests that complete multivessel PCI may improve long-term outcomes compared with culprit-only intervention.

Objective

This study evaluates long-term clinical outcomes associated with multivessel PCI in ACS patients, focusing on mortality, recurrent myocardial infarction, repeat revascularization, major adverse cardiovascular events (MACE), and quality of life.

Methods

A comprehensive review of randomized controlled trials, observational studies, and registry-based analyses published between 2010 and 2025 was performed. Outcomes were synthesized from major studies evaluating complete revascularization versus culprit-only PCI.

Results

Multivessel PCI demonstrated significant reductions in recurrent myocardial infarction, ischemia-driven revascularization, and major adverse cardiovascular events. Long-term survival benefits were observed in selected high-risk populations, particularly among STEMI patients undergoing staged complete revascularization.

Conclusion

Complete multivessel PCI appears to provide superior long-term cardiovascular outcomes compared with culprit-only PCI in carefully selected ACS patients. Future studies should focus on precision-guided revascularization strategies and integration of physiological assessment tools.

Keywords

Acute Coronary Syndrome

Multivessel PCI

Complete Revascularization

Coronary Artery Disease

STEMI

NSTEMI

Long-Term Outcomes

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