Management of Culprit and Non-Culprit Lesions in Acute Coronary Syndrome

DOI: 10.2478/jim-2021-0009


Multivessel coronary artery disease is defined by the presence of a significant stenosis (≥50% diameter) in two or more epicardial coronary vessels, it usually occurs at more than 50% of patients with ST-segment elevation myocardial infarction. The latest guidelines indicate revascularization of non-culprit artery with a recommendation of class IIB. However the management of non-culprit lesions in patients with acute coronary syndrome is still a matter of debate. This article presents the most recent concepts related to management of culprit and non-culprit coronary lesions, based on advanced imaging approach, in order to identify high-risk patients and prevent further acute coronary syndromes.