The FLOWER-MI (presented simultaneously at ACC 2021 and NEJM) hit FFR hard. Its outcomes showed that STEMI patients presenting other non-culprit lesions did not benefit from FFR guided revascularization vs PCI. As it happens with most large studies with unexpected results in the general population, the sub-studies that follow select better samples and, as a…
Visual Assessment for Non-Culprit Lesion Revascularization
There is evidence in favor of complete revascularization in the context of ST elevation MI with multivessel disease where primary PCI has been successful. However, the small print in these studies should be read carefully. Should revascularization be completed during index intervention, index hospitalization or after discharge? Should complete revascularization be based on visual assessment,…
Compare-Acute Sub-Study: Natural History of Non-Culprit Lesions in MI
The aim of this study was to determine the prognostic value of fractional flow reserve (FFR) of non-culprit lesions in STEMI patients. We analyzed data of all Compare-Acute patients (Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With MVD) after PCI, from lesions assessed with FFR and treated medically. The treating…
Are Non-Culprit Lesions Really Innocent?
In recent times, a lot has been said about reducing the duration or intensity of antiplatelet therapy following percutaneous coronary intervention (PCI) regardless initial indications. All evidence in support of these arguments might be failing to show the risk of non-culprit lesion events in patients with acute coronary syndromes (ACS). Potent and prolonged antithrombotic therapies…