What are the recommendations with regard to the optimal timing of nonculprit vessel PCI?
Recommendations in the 2013 STEMI guideline with regard to PCI of a non infarct-related artery at a time separate from primary PCI in patients who have spontaneous symptoms and myocardial ischemia or who have intermediate- or high-risk findings on noninvasive testing (Section 6.3 of that guideline) remain operative. Although several observational studies [19,20] and a network meta-analysis [13] have suggested that multi- vessel staged PCI may be associated with better out- come than multivessel primary PCI, there are insufficient observational data and no randomized data at this time to inform a recommendation with regard to the optimal timing of nonculprit vessel PCI. Additional trial data that will help further clarify this issue are awaited.