PMID- 34341096 OWN - NLM STAT- MEDLINE DCOM- 20211129 LR - 20211129 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 8 IP - 2 DP - 2021 Jul TI - Vessel fractional flow reserve in assessment of non-culprit lesions in ST elevation myocardial infarction. LID - 10.1136/openhrt-2021-001691 [doi] LID - e001691 AB - OBJECTIVES: We sought to evaluate the physiology of non-culprit lesions by using vessel fractional flow reserve (vFFR) among patients with ST elevation myocardial infarction (STEMI) and multivessel disease (MVD). METHODS: From January 2017 to December 2019, 354 patients with STEMI in the Taipei Veterans General Hospital Acute Myocardial Infarction Registry were screened. Patients who underwent successful primary percutaneous coronary intervention (PCI) for culprit lesions, with at least one non-culprit lesion with stenosis of >/=50%, were eligible. vFFR was computed retrospectively. RESULTS: A total of 156 patients with 217 non-culprit lesions were eligible for this study. Aortic root pressure and two good angiograms were available for 139 non-culprit lesions for vFFR analysis. Based on the vFFR analysis, 59 non-culprit lesions (43.2%) had a vFFR value >0.80, and PCI was deferred in 45 lesions (76.3%). Meanwhile, 80 non-culprit lesions (56.8%) had a vFFR value 0.80 (6.3% vs 1.7%, HR: 3.59, 95% CI: 0.42 to 30.8, p=0.243). CONCLUSION: Functional incomplete revascularisation is common among patients with STEMI and MVD. The adoption of vFFR to assess non-culprit lesions may reclassify the coronary revascularisation strategy that is usually guided by angiography only in this acute setting. CI - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Chang, Chun Chin AU - Chang CC AUID- ORCID: 0000-0003-2799-1185 AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands. FAU - Chuang, Ming Ju AU - Chuang MJ AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Lee, Yin Hao AU - Lee YH AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Tsai, Yi Lin AU - Tsai YL AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Lu, Ya Wen AU - Lu YW AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Chou, Ruey Hsing AU - Chou RH AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Wu, Cheng Hsueh AU - Wu CH AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Lu, Tse Min AU - Lu TM AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Healthcare and services center, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Huang, Po Hsun AU - Huang PH AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan huangbsvgh@gmail.com. AD - Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Lin, Shing Jong AU - Lin SJ AD - Department of Internal Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei City, Taiwan. AD - Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't PL - England TA - Open Heart JT - Open heart JID - 101631219 SB - IM MH - Aged MH - Coronary Angiography MH - Coronary Vessels/diagnostic imaging/*physiopathology/surgery MH - Female MH - Follow-Up Studies MH - Fractional Flow Reserve, Myocardial/*physiology MH - Humans MH - Male MH - *Percutaneous Coronary Intervention MH - *Registries MH - Retrospective Studies MH - ST Elevation Myocardial Infarction/diagnosis/*physiopathology/surgery MH - Time Factors PMC - PMC8330569 OTO - NOTNLM OT - acute coronary syndrome OT - coronary artery disease OT - coronary stenosis COIS- Competing interests: None declared. EDAT- 2021/08/04 06:00 MHDA- 2021/11/30 06:00 PMCR- 2021/08/02 CRDT- 2021/08/03 05:49 PHST- 2021/04/14 00:00 [received] PHST- 2021/07/13 00:00 [accepted] PHST- 2021/08/03 05:49 [entrez] PHST- 2021/08/04 06:00 [pubmed] PHST- 2021/11/30 06:00 [medline] PHST- 2021/08/02 00:00 [pmc-release] AID - openhrt-2021-001691 [pii] AID - 10.1136/openhrt-2021-001691 [doi] PST - ppublish SO - Open Heart. 2021 Jul;8(2):e001691. doi: 10.1136/openhrt-2021-001691.