Clinical implication of QFR in patients with ST-segment elevation myocardial infarction after drug-eluting stent implant
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ORIGINAL PAPER
Clinical implication of QFR in patients with ST‑segment elevation myocardial infarction after drug‑eluting stent implantation Jiani Tang1 · Jiapeng Chu1 · Hanjing Hou2 · Yan Lai1 · Shengxian Tu3 · Fei Chen1 · Yian Yao1 · Zi Ye1 · Yanhua Gao1 · Yu Mao1 · Shaowei Zhuang2 · Xuebo Liu1 Received: 17 July 2020 / Accepted: 7 October 2020 © Springer Nature B.V. 2020
Abstract The feasibility and prognostic value of quantitative flow ratio (QFR) after percutaneous coronary intervention (PCI) in STsegment elevation myocardial infarction (STEMI) patients have not been assessed. The aim of this study was to investigate the prognostic utility of post-PCI QFR to predict outcomes in STEMI and determine the influence of functional results, in both culprit and nonculprit lesions, after PCI. Patients undergoing PCI of culprit lesions and receiving staged procedures of nonculprit lesions after 7 days were enrolled from 2 centers and underwent post-PCI QFR. The primary outcome was the vessel-oriented composite endpoints (VOCEs), defined as vessel-related cardiovascular death, vessel-related myocardial infarction, and target vessel revascularization. Four hundred fifteen vessels (186 culprit lesions and 219 nonculprit lesions) in 186 patients were analyzed. Measured at staged PCI, the post-PCI QFR of culprit lesions was significantly lower than that of nonculprit lesions (0.92 ± 0.10 versus 0.95 ± 0.08, p 1 mm in at least 2 contiguous limb ECG leads or a newly developed left bundle branch block. Exclusion criteria included significant left main disease (stenosis > 50% by visual estimation), ostial right coronary artery (RCA) target lesions, previous coronary artery bypass graft (CABG) surgery, cardiogenic shock, patients with a life expectancy
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