Robustness of Fractional Flow Reserve for Lesion Assessment in Non-Infarct-Related Arteries of Patients With Myocardial Infarction

• Type of Material: Article
• Authors: Jin-Sin Koh, Emory University; Habib Samady, Emory University
• Language: English
• Date: 2019-05-07
• Publisher: Wiley Open Access: Creative Commons Attribution Non-Commercial
• Publication Version: Final Published Version
• Copyright Statement: © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1161/JAHA.119.012456
• Title of Journal or Parent Work: Journal of the American Heart Association
• ISSN: 2047-9980
• Volume: 8
• Issue: 9
• Start Page: e012456
• End Page: e012456
• Keywords: Editorials; coronary microcirculation; coronary revascularization; coronary flow reserve; coronary microvascular resistance
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Two recent randomized trials (PRAMI [Preventive Angioplasty in Acute Myocardial Infarction] trial and CvLPRIT [Complete versus Lesion‐only Primary PCI trial]) have demonstrated reduced rates of major cardiovascular events with a strategy of complete revascularization compared with infarct‐related artery (IRA) only revascularization in patients with ST‐segment–elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MV‐CAD).1, 2 On the basis of these studies, the American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions guideline changed the recommendation for non–IRA revascularization in patients with STEMI from class III to class IIb,3 and the European Society of Cardiology guidelines now recommend nonculprit vessel PCI of patients with STEMI and MV‐CAD as class IIA.4 The question of whether fractional flow reserve (FFR) could help guide revascularization of the nonculprit vessels in patients with STEMI and MV‐CAD, as it has been shown to effectively do in patients with stable CAD,5, 6 required evidence that FFR on the nonculprit bed is relatively accurate early after MI.