ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2025
Functional or anatomical assessment of non-culprit lesions in acute myocardial infarction.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Regulation of acute myocardial infarction by CircTMCC1 through mitochondrial dysfunction and AMPK/mTOR-driven M1 macrophage polarization: role in QFR assessment.Cell death discovery · 2026Article
- Strategies and Timing of Complete Revascularization in STEMI Patients with Multivessel Coronary Artery Disease.Journal of clinical medicine · 2026Review
- Prognostic impact of high-risk plaque morphology and impaired physiology in untreated non-culprit coronary lesions: a systematic review and meta-analysis.International journal of cardiology. Heart & vasculature · 2026Article
- Current status and mechanistic insights into nontarget coronary lesions in patients with diabetes and early abnormal glucose metabolism.World journal of diabetes · 2025Review
- The future of complete revascularisation: prioritising imaging-guided non-culprit lesion assessment.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- Functional assessment in acute coronary syndrome: a systematic review of acute versus staged interventions.REC, interventional cardiology · 2025Article
- Association between residual cholesterol and vulnerable non-culprit lesions progressing to major adverse cardiovascular events.Frontiers in endocrinology · 2025Observational
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17 authors.
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Abstract
backgroundPrevious studies have reported the value of quantitative flow ratio (QFR) to assess the physiological significance of non-culprit lesions (NCLs) in acute myocardial infarction (AMI) patients and of optical coherence tomography (OCT)-defined thin-cap fibroatheroma (TCFA) to identify non-culprit vulnerable plaques.
aimsWe sought to systematically compare long-term NCL-related clinical prognosis in an AMI population utilising acute Murray fractal law-based QFR (μQFR) values and OCT-defined TCFA.
methodsThree-vessel OCT imaging and μQFR assessment were conducted in 645 AMI patients, identifying 1,320 intermediate NCLs in non-infarct-related arteries. The primary endpoint was a composite of cardiac death, NCL-related non-fatal myocardial infarction (MI), and NCL-related unplanned coronary revascularisation, with follow-up lasting up to 5 years.
resultsThe primary endpoint occurred in 59 patients (11.1%). OCT-defined TCFA independently predicted patient-level (adjusted hazard ratio [HR] 3.05, 95% confidence interval [CI]: 1.80-5.19) and NCL-specific primary endpoints (adjusted HR 4.46, 95% CI: 2.33-8.56). The highest event rate of 29.6% was observed in patients with NCLs that were TCFA (+) with μQFR ≤0.80, compared to 16.3% in those that were also TCFA (+) but with μQFR>0.80, 6.0% in those that were TCFA (-) with μQFR ≤0.80, and 6.6% in those that were TCFA (-) with μQFR>0.80 (log-rank p<0.001). TCFA was an independent predictor for the primary endpoint in ST-segment elevation MI (STEMI; adjusted HR 3.27, 95% CI: 1.67-6.41) and non-STEMI (adjusted HR 3.26, 95% CI: 1.24-8.54) patients, whereas μQFR ≤0.80 was not.
conclusionsWhen assessing NCLs during the index procedure in AMI patients, OCT-defined TCFA serves as the dominant prognostic predictor for long-term clinical outcomes, rather than μQFR-determined physiological significance.
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