Key result
Fractional flow reserve measurements are reliable and safe for assessing non-culprit lesions in acute myocardial infarction, though clinical implications are currently being tested in randomized trials.
Why the study?
Does an FFR-guided treatment strategy improve outcomes for non-culprit lesions in STEMI patients with multi-vessel disease?
Does an FFR-guided treatment strategy improve outcomes for non-culprit lesions in STEMI patients with multi-vessel disease?
FFR measurements may be a valuable guide for treating non-culprit lesions in STEMI patients with multi-vessel disease, though definitive clinical implications await the results of ongoing randomized trials.
Supports FFR assessment of non-culprit lesions in AMI without practice change; leaves open outcome benefits pending RCTs.
In patients presenting with ST-segment elevation myocardial infarction (STEMI) and multi-vessel disease (MVD), the optimal therapy for non-culprit lesions is still a matter of debate. While guidelines discourage a concomitant treatment of infarct- and non-infarct-related arteries, recent studies document advantages of a complete (preventive) revascularization during primary percutaneous coronary intervention. Such an approach, however, may result in overtreatment, because angiography does not provide robust information about the functional severity of MVD. Fractional flow reserve (FFR) measurements can be a valuable guide for non-culprit lesions in acute myocardial infarction, but so far, only the reliability and safety of FFR measurements have been established in this setting. The clinical implications of an FFR-guided treatment strategy in STEMI patients with MVD are currently being tested in a large randomized trial.
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Sulimov et al. (2015) conducted a review in ST-segment elevation myocardial infarction (STEMI) and multi-vessel disease (MVD). Fractional flow reserve (FFR) vs. Culprit-only percutaneous coronary intervention was evaluated. Fractional flow reserve measurements are reliable and safe for assessing non-culprit lesions in acute myocardial infarction, though clinical implications are currently being tested in randomized trials.
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