TY - JOUR T1 - Timing and completeness of revascularisation in acute coronary syndromes JF - Heart JO - Heart DO - 10.1136/heartjnl-2020-316743 SP - heartjnl-2020-316743 AU - Jorge Sanz-Sánchez AU - Giulio G Stefanini Y1 - 2021/06/24 UR - http://heart.bmj.com/content/early/2021/06/23/heartjnl-2020-316743.abstract N2 - Learning objectivesPatients presenting with non-ST-segment elevation acute coronary syndrome (NSTEACS)In high-risk patients presenting with NSTEACS, coronary angiography should be performed as soon as possible, within 24 hours from hospital admission.Revascularisation of non-culprit lesion in patients with NSTEACS should be attempted either during acute procedure (in stable and low-anatomical complexity patients), during the index hospitalisation or after hospital discharge.It is reasonable to consider a physiology-guided revascularisation of non-culprit lesions in patients with NSTEACS with multivessel disease.Patients presenting with ST-segment elevation myocardial infarction (STEMI)Percutaneous coronary intervention (PCI) of the culprit lesion in patients with STEMI must be performed as soon as possible in patients presenting within 48 hours from symptoms onset.In patients with STEMI presenting >48 hours after symptoms onset, PCI should be performed in case of clinical and/or electrocardiographic evidence of ischaemia.Revascularisation of non-culprit lesion in patients with STEMI should be attempted either during the index hospitalisation or early after hospital discharge.Both angio-guided and physiology-guided strategies are suitable to complete revascularisation in patients presenting with STEMI and multivessel disease.Patients presenting with cardiogenic shockIn patients with acute coronary syndrome complicated with cardiogenic shock, PCI should be confined to the culprit lesion in the acute emergency setting.Acute coronary syndrome (ACS) represents one of the primary causes of mortality and loss of disability-adjusted life years worldwide despite recent pharmacological and technological innovations.1 Percutaneous coronary intervention (PCI) of the culprit vessel remains the standard of care for patients presenting with ACS.1 Nevertheless, multivessel coronary disease is found in up to 60% of patients presenting with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTEACS), and is associated with worse clinical outcomes and increased mortality.2The optimal timing to undergo coronary angiography and the best strategy for treatment of non-culprit lesions have been subject to controversies for the past two decades and are yet to be determined. Therefore, the aim of this article was … ER -