Key result
Acute FFR-guided complete revascularization may improve short-term outcomes in multivessel ACS, but long-term benefit remains unproven.
Why the study?
The management of non-culprit lesions in patients with acute coronary syndrome remains a matter of debate despite guideline recommendations.
Does not support routine FFR-guided complete revascularization in acute multivessel ACS; leaves open long-term efficacy pending randomized trials.
Multivessel coronary artery disease, defined by the presence of a significant stenosis (≥50% diameter) in two or more epicardial coronary vessels, usually occurs in more than 50% of patients with ST-segment elevation myocardial infarction. The latest guidelines indicate revascularization of the 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 the management of culprit and non-culprit coronary lesions, based on advanced imaging approaches, in order to identify high-risk patients and prevent further acute coronary syndromes.
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Gerculy et al. (2021) conducted a review in Acute Coronary Syndrome. Complete revascularization vs. Culprit-lesion-only PCI was evaluated. FFR-guided complete revascularization of multivessel coronary artery disease in the acute phase of acute coronary syndrome may improve short-term outcomes, though long-term benefits remain unproven.
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