Key result
An FFR-guided strategy for non-culprit vessels 3 weeks after a STEMI yielded a false negative result (FFR 0.87), followed by a short-term sub-occlusion of the evaluated vessel 2 months later.
Case Report (n=1)
No
This case highlights that FFR of non-culprit vessels early after STEMI may be falsely negative due to microvascular dysfunction or fail to identify vulnerable plaques, warranting cautious interpretation.
FFR of non-culprit vessels 3 weeks post-STEMI may yield false negatives; single case leaves open optimal timing and microvascular effects.
BACKGROUND: Multi-vessel disease is frequent in patients presenting with myocardial infarction and have an important prognostic impact. The decision to proceed to revascularization in non-culprit vessels can be postponed until ischemia is proven in non-invasive stress tests. On the other hand, there is an increasing evidence to support the role of fractional flow reserve (FFR) in acute coronary syndrome setting. CASE PRESENTATION: We report a case in which a FFR-guided strategy for non-culprit vessels, 3 weeks after an ST-segment elevation myocardial infarction, was followed by a short-term sub-occlusion of the evaluated vessel. CONCLUSION: The timing of the coronary microcirculation recovery post-myocardial infarction, avoiding a possible false negative FFR, and the diagnostic gaps between ischemia and plaque vulnerability are under discussion. An FFR-guided strategy in this setting should be interpreted with caution.
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Leite et al. (2015) conducted a case report in ST-segment elevation myocardial infarction with multi-vessel disease (n=1). Fractional flow reserve (FFR) assessment was evaluated on Sub-occlusion of the evaluated vessel. An FFR-guided strategy for non-culprit vessels 3 weeks after a STEMI yielded a false negative result (FFR 0.87), followed by a short-term sub-occlusion of the evaluated vessel 2 months later.
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