The optimal strategy for revascularization in patients with NSTEACS who had multivessel coronary artery disease. A lack of evidence exists about the role of complete coronary revascularization by PCI in patients with non-ST segment elevation acute coronary syndrome (NSTEACS). Till now, ACC/AHA and ESC guidelines are not clear regarding the optimal strategy for revascularization in NSTEACS patients with multivessel coronary artery disease. In this setting, identification of the culprit lesion by angiography only could be challenging. The objective is to compare the hospital and short-term (6 months) outcomes of 3 different coronary revascularization strategies in NSTEACS patients with and multivessel coronary artery disease. Our study was a prospective study that included 90 patients who presented with acute chest pain and were diagnosed with NSTEACS. The patients were divided into 3 groups according to the plan of management: total revascularization group (total group), staged revascularization group (staged group), and functional revascularization group using FFR (FFR group). We studied the effect of demographic data, risk factors, and angiographic and procedural criteria on hospital and short-term outcomes. No significant statistical difference was seen among the three groups regarding the hospital outcome (in-stent thrombosis, unstable angina, and renal impairment). Also, the short-term (after 6 months) outcome regarding myocardial infarction, hospitalization, stroke, and cardiac death did not differ significantly between the three groups. Considering NSTEACS patients with multivessel disease, different coronary revascularization strategies (total, staged, or FFR) are comparable regarding immediate and short-term (6 months) clinical follow-up. FFR can change the preplanned management, and less number of stents per patient is needed when FFR is utilized.

中文翻译：

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NSTEACS 多支血管病变患者的全血运重建与分期与功能性血运重建

患有多支冠状动脉疾病的 NSTEACS 患者血运重建的最佳策略。缺乏证据表明 PCI 对非 ST 段抬高急性冠脉综合征 (NSTEACS) 患者进行完全冠脉血运重建的作用。迄今为止，ACC/AHA 和 ESC 指南对 NSTEACS 多支冠状动脉疾病患者血运重建的最佳策略尚不明确。在这种情况下，仅通过血管造影识别罪犯病变可能具有挑战性。目的是比较 3 种不同冠状动脉血运重建策略在 NSTEACS 和多支冠状动脉疾病患者中的住院和短期（6 个月）结果。我们的研究是一项前瞻性研究，其中包括 90 名出现急性胸痛并被诊断为 NSTEACS 的患者。根据治疗计划将患者分为3组：完全血运重建组（总组）、分期血运重建组（分期组）和使用FFR的功能性血运重建组（FFR组）。我们研究了人口统计学数据、危险因素、血管造影和手术标准对医院和短期结果的影响。三组患者的住院结局（支架内血栓形成、不稳定型心绞痛和肾功能损害）无显着统计学差异。此外，关于心肌梗塞、住院、中风和心源性死亡的短期（6 个月后）结果在三组之间没有显着差异。考虑到多支血管病变的 NSTEACS 患者，不同的冠状动脉血运重建策略（总的、分期的或 FFR）在即刻和短期（6 个月）临床随访方面具有可比性。FFR 可以改变预先计划的管理，当使用 FFR 时，每位患者需要的支架数量更少。