Clinical study of fractional flow reserve guided staging complete revascularization of non-infarct related artery in patients with ST-elevation myocardial infarction and multi-vessel disease

Abstract

Objective To evaluate the clinical value of fractional flow reserve(FFR)for non-infarct related artery(non-IRA)staged complete revascularization in patients with ST-segment elevation myocardial infarction(STEMI)and multiple vessel disease. Methods Selected STEMI patients with multiple vessel disease accepting emergency PCI and planed to be staged PCI in the treatment of non-IRA in our hospital.Ninety Patients were randomly divided into FFR guiding group(n=45)and coronary angiography(CAG)guiding group(n=45). In FFR group, FFR were performed in the diseased vessels with 70%-90% stenosis and FFR<0.80 as the indication for PCI treatment; Stenosis of more than 70% lesions as the indication for PCI treatment in CAG Group.PCI time, the number of stent implantation, the dosage of contrast agent, length of stay, hospital costs and surgical complications were compared between the two groups.Patients were followed up for 6 months and major adverse cardiovascular events were compared between the two groups. Results In FFR group the number of stent placement and contrast medium dose was significantly less than those in CAG group(1.68±0.75 vs. 2.83±0.54, t=7.662, P 0.05). Conclusions In patients with STEMI and multiple vessel disease, non-IRA staged complete revascularization under the guidance of FFR can reduce the number of stent implantation and the dosage of contrast agent, and the rate of revascularization after 6 months. Key words: Fractional flow reserve, myocardial; Coronary artery disease; Non infarct related artery; Angioplasty, transluminal, percutaneous coronary