PMID- 34581424
OWN - NLM
STAT- MEDLINE
DCOM- 20230424
LR  - 20230504
IS  - 1898-018X (Electronic)
IS  - 1897-5593 (Print)
IS  - 1898-018X (Linking)
VI  - 30
IP  - 2
DP  - 2023
TI  - The efficacy and safety of quantitative flow ratio-guided complete 
      revascularization in patients with ST-segment elevation myocardial infarction and 
      multivessel disease: A pilot randomized controlled trial.
PG  - 178-187
LID - 10.5603/CJ.a2021.0111 [doi]
AB  - BACKGROUND: In patients with ST-segment elevation myocardial infarction (STEMI) 
      and multivessel disease (MVD), the treatment strategy for non-infarct-related 
      artery (non-IRA) remains controversial. Quantitative flow ratio (QFR) is a new 
      angiography-based physiological assessment index. However, there is little 
      evidence on the practical clinical application of QFR. METHODS: Two hundred and 
      twenty-nine patients with STEMI and MVD were recruited for this study. Patients 
      were randomly assigned to either receive QFR-guided complete revascularization 
      (QFR-G-CR) of non-IRA or receive no further invasive treatment. The primary (1 degrees ) 
      endpoint analyzed included death due to all causes, non-fatal myocardial 
      infarction (MI), and ischemia-induced revascularization at 12 months 
      post-surgery. Secondary (2 degrees ) endpoints included cardiovascular death, unstable 
      angina, stent thrombosis, New York Heart Association (NYHA) class IV heart 
      failure, and stroke at 1 year post surgery. Massive bleeding and 
      contrast-associated acute kidney injury (CAKI) were used as safety endpoints. 
      RESULTS: Around the 12 month follow up, the 1o outcome was recorded in 11/115 
      patients (9.6%) in the QFR-G-CR population, relative to 23/114 patients (20.1%) 
      in the IRA-only PCI population (hazard ratio [HR]: 0.45; 95% confidence interval 
      [CI]: 0.22-0.92; p = 0.025). Unstable angina in 6 (5.2%) and 16 (14.0%) patients 
      (HR: 0.36; 95% CI: 0.14-0.92; p = 0.026), respectively. No marked alterations 
      were found in the massive bleeding and CAKI categories. CONCLUSIONS: In 
      conclusion, STEMI and MVD patients can benefit from QFR-G-CR of non-IRA lesions 
      in the initial stages of acute MI. This can help reduce incidences of major 
      adverse cardiovascular events and unstable angina, relative to IRA treatment 
      only. Chinese Clinical Trial Registration number: ChiCTR2100044120.
FAU - Zhang, Jing
AU  - Zhang J
AD  - Department of Cardiology, Thoracic Clinical College, Tianjin Medical University, 
      Tianjin, China.
AD  - Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, 
      China.
FAU - Yao, Mingyan
AU  - Yao M
AD  - Department of Endocrinology, Baoding No.1 Central Hospital, Baoding, China.
FAU - Jia, Xinwei
AU  - Jia X
AD  - Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, 
      China. xinweij@126.com.
FAU - Feng, Huiping
AU  - Feng H
AD  - Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, 
      China.
FAU - Fu, Jingjing
AU  - Fu J
AD  - Department of Cardiology, Fengfeng General Hospital, North China Medical and 
      Health Group, Handan, China.
FAU - Tang, Wei
AU  - Tang W
AD  - Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, 
      China.
FAU - Cong, Hongliang
AU  - Cong H
AD  - Department of Cardiology, Thoracic Clinical College, Tianjin Medical University, 
      Tianjin, China.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20210928
PL  - Poland
TA  - Cardiol J
JT  - Cardiology journal
JID - 101392712
SB  - IM
MH  - Humans
MH  - *ST Elevation Myocardial Infarction/diagnosis/surgery/etiology
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Pilot Projects
MH  - Treatment Outcome
MH  - *Myocardial Infarction/etiology
MH  - Angina, Unstable
MH  - *Coronary Artery Disease/diagnosis/diagnostic imaging
MH  - Myocardial Revascularization
PMC - PMC10129263
OTO - NOTNLM
OT  - ST-segment elevation myocardial infarction
OT  - complete revascularization
OT  - multivessel disease
OT  - physiological assessment
OT  - quantitative flow ratio
COIS- Conflict of interest: None declared
EDAT- 2021/09/29 06:00
MHDA- 2023/04/24 06:41
PMCR- 2023/04/17
CRDT- 2021/09/28 09:55
PHST- 2021/03/23 00:00 [received]
PHST- 2021/08/27 00:00 [accepted]
PHST- 2021/08/13 00:00 [revised]
PHST- 2023/04/24 06:41 [medline]
PHST- 2021/09/29 06:00 [pubmed]
PHST- 2021/09/28 09:55 [entrez]
PHST- 2023/04/17 00:00 [pmc-release]
AID - VM/OJS/J/75707 [pii]
AID - cardj-30-2-178 [pii]
AID - 10.5603/CJ.a2021.0111 [doi]
PST - ppublish
SO  - Cardiol J. 2023;30(2):178-187. doi: 10.5603/CJ.a2021.0111. Epub 2021 Sep 28.