Instantaneous wave-free ratio for the assessment of nonculprit lesions in patients with acute coronary syndrome

Abstract Background A physiological assessment with the fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) is strongly recommended by European Guidelines of Revascularization to guide percutaneous coronary intervention (PCI) decision making in intermediate stenosis. However, data supporting its use pro-inflammatory setting ACS weak. Purpose To analyze usefulness a evaluation iFR nonculprit lesions patients ACS. Methods Retrospective multicenter study including and underwent successful revascularization culprit vessel had other nonculpritlesions physiologically evaluated between January 2017 December 2019. The primary endpoint was composite cardiac death, nonfatal myocardial infarction, stent thrombosis new (MACEs). Results total 356 472 were included. mean age 66±11 years. clinical presentation non-ST-segment elevation infarction (NSTEMI) 235 ST-segment (STEMI) 121 patients. After follow-up period 22±10 months, occurred 32 (9%). There no differences outcomes regarding induced treatment strategy (patients all revascularized vs. at least one lesion deferred for revascularization, 10.5 vs 8.4%, p=0.476). Conclusion seems be safe, an acceptable percentage MACEs mid-term follow-up. Funding Acknowledgement Type funding sources: None. FlowchartSurvival curves group