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Author Notes:
Correspondence to: Habib Samady, MD, Interventional Cardiology, Emory University School of Medicine, 1364 Clifton Rd, Ste F606, Atlanta, GA 30322. E-mail: hsamady@emory.edu
Samady reports research grants from Medtronic, Abbott Vascular, and Philips; and is a consultant for and on the advisory board of Philips.
Koh has no disclosures to report.
Subject:
Keywords:
- Editorials
- coronary flow reserve
- coronary microcirculation
- coronary microvascular resistance
- coronary revascularization
Robustness of Fractional Flow Reserve for Lesion Assessment in Non-Infarct-Related Arteries of Patients With Myocardial Infarction
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.
Copyright information:
© 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).
