Role of Physiology in the Management of Nonculprit Lesions in Acute Coronary Syndrome

Current international clinical practice guidelines recommend complete revascularization for patients with ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease1 on the basis of evidence from randomized, controlled trials.2 The COMPLETE trial (Complete versus Culprit-Only Revascularization Strategies to Treat Multivessel Disease after Early PCI for STEMI), which included 4041 patients with STEMI, showed a 26% lower risk of death from cardiovascular causes or myocardial infarction and a greater improvement in angina scores after 3 years of follow-up among patients who had been assigned to undergo complete revascularization of angiographically significant nonculprit lesions than among patients who had had no . . .