Table 1.1

STEMI—Immediate Revascularization by PCI

IndicationAppropriate Use Score (1–9)
Revascularization of the Presumed Culprit Artery by PCI (Primary PCI)
1.
  • Less than or equal to 12 hours from onset of symptoms

A (9)
2.
  • Onset of symptoms within the prior 12–24 hours AND

  • Severe HF, persistent ischemic symptoms, or hemodynamic or electrical instability present

A (8)
3.
  • Onset of symptoms within the prior 12–24 hours AND

  • Stable without severe HF, persistent ischemic symptoms, or hemodynamic or electrical instability

M (6)
Successful Treatment of the Culprit Artery by Primary PCI Followed by Immediate Revascularization of 1 or More Nonculprit Arteries During the Same Procedure
4.
  • Cardiogenic shock persisting after PCI of the presumed culprit artery

  • PCI or CABG of 1 or more additional vessels

A (8)
5.
  • Stable patient immediately following PCI of the presumed culprit artery

  • One or more additional severe stenoses

M (6)
6.
  • Stable patient immediately following PCI of the presumed culprit artery

  • One or more additional intermediate (50%–70%) stenoses

M (4)

The number in parenthesis next to the rating reflects the median score for that indication.

A = appropriate; CABG = coronary artery bypass graft; HF = heart failure; M = may be appropriate; PCI = percutaneous coronary intervention; R = rarely appropriate; STEMI = ST-segment elevation myocardial infarction.