Fractional flow reserve in assessment of intermediate non-culprit lesions in acute myocardial infarction

Article published in J. Pharm. Pharmacogn. Res., vol. 11, no. 5, pp. 823-832, Sep-Oct 2023.

DOI: https://doi.org/10.56499/jppres23.1696_11.5.823

Original Article

Do Truong Son Chau^1,2, Quang Binh Truong⁴, Do Anh Nguyen², Manh Thong Le², Dinh Dat Nguyen², Anh Tien Hoang^1,3*

¹Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.

²Department of Interventional Cardiology, Gia Dinh People’s Hospital, Ho Chi Minh, Vietnam.

³Department of Medicine, Hue University Hospital, Hue University, Hue, Vietnam.

⁴University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh, Vietnam.

*E-mail: hatien@hueuni.edu.vn

Abstract

Context: Percutaneous coronary intervention (PCI) of intermediate non-culprit arteries can reduce death or heart attack risk in patients with acute myocardial infarction and multivessel coronary artery disease.

Aims: To compare the effectiveness of fractional flow reserve (FFR)-guided PCI with angiography-guided PCI for intermediate non-culprit lesions in patients with acute myocardial infarction and multivessel coronary artery disease.

Methods: In this cohort study, acute myocardial infarction patients with multivessel coronary artery disease who had successful percutaneous coronary intervention of the culprit artery were divided into group of patients receiving FFR-guided PCI (FFR≤0.80, n = 31) and group of patients receiving angiography-guided PCI (diameter stenosis of 50-90%, n = 62) for lesions in non-culprit arteries. These two groups were followed for at least 1 year for major adverse cardiovascular events.

Results: There was no statistically significant difference in major cardiovascular events between FFR-guided percutaneous coronary intervention group and angiography-guided percutaneous coronary intervention group. However, FFR-guided percutaneous coronary intervention group had a lower mortality rate compared to the angiography-guided percutaneous coronary intervention group (3.2% vs. 4.8%). Additionally, there were no reported cases of myocardial infarction in angiography-guided PCI group, while angiography-guided PCI group had a rate of 1.6%.

Conclusions: This study found that it remains uncertain whether FFR-guided PCI is superior than angiography-guided PCI for intermediate non-culprit lesions in patients with acute myocardial infarction and multivessel coronary artery disease.