Table 1.

2021 ACC/AHA/SCAI Coronary Artery Revascularization Guideline 5.2 for Revascularization of the Noninfarct Artery in Patients With STEMI

COR	LOE	Recommendations
1	A	1. In selected patients in hemodynamically stable condition with STEMI and multivessel disease, after successful primary PCI, staged PCI of a significant noninfarct artery stenosis is recommended to reduce the risk of death or MI.1, 2, 3, 4, 5, 6
2a	C-EO	In selected patients with STEMI with complex multivessel noninfarct artery disease, after successful primary PCI, elective CABG is reasonable to reduce the risk of cardiac events.
2b	B-R	In selected patients in hemodynamically stable condition with STEMI and low-complexity multivessel disease, PCI of a noninfarct artery stenosis may be considered at the time of primary PCI to reduce cardiac event rates.3,4,6
3: Harm	B-R	In patients with STEMI complicated by cardiogenic shock, routine PCI of a noninfarct artery at the time of primary PCI should not be performed because of the higher risk of death or renal failure.2

ACC = American College of Cardiology; AHA = American Heart Association; B-R = B-randomized; CABG = coronary artery bypass grafting; C-EO = C-expert opinion; COR = class of recommendation; LOE = level of evidence; MI = myocardial infarction; PCI = percutaneous coronary intervention; SCAI = Society for Cardiovascular Angiography and Interventions; STEMI-ST = elevation myocardial infarction.

Reprinted from Lawton et al.⁷