Background Coronary physiology-guided PCIs are recommended worldwide. However, invasive coronary physiology methods prolong the procedure, create additional risks for the patients, and prolong the fluoroscopy time for an interventional cardiologist. Otherwise, there is a noninvasive coronary physiology evaluation method, QFR, that can be safely used even in STEMI patients. Methods A total of 198 patients admitted with STEMI and at least one intermediate (35–75%) diameter stenosis other than the culprit artery between July 2020 and June 2021 were prospectively included in this single-center study. All patients were randomized into one of two groups (1 - QFR-guided PCI; 2 - visual-estimation-only guided PCI). A 12-month follow-up with echocardiography, exercise stress test, and quality of life evaluation was performed in all included patients. For the QOF evaluation, the Seattle Angina Score Questionnaire was chosen. Statistical analysis was performed using the Kolmogorov–Smirnov test, Student’s t-test, Mann–Whitney U test, Pearson’s chi-squared test and Kaplan–Meier estimator. Results Ninety-eight (49.5%) patients were randomized to the first group, and 100 (50.5%) patients were included in the second group. Statistically, significantly more patients had a medical history of dyslipidemia (98 vs. 91, p = 0.002) and slightly better left ventricular ejection fraction (42.21 ± 7.88 vs. 39.45 ± 9.62, p = 0.045) in the QFR group. Six fewer patients required non-culprit artery revascularization within the 12-month FU in the QFR group (1.02% vs. 6%, p = 0.047). Survival analysis proved that patients in the Angio group had a more than 6-fold greater risk for death within a 12-month period after MI (OR 6.23, 95% CI 2.20-17.87, p = 0.006), with the highest mortality risk within the first two months after initial treatment. Conclusion Using QFR in non-culprit lesions in patients with ST-elevation myocardial infarction reduces mortality and revascularization at the 12-month follow-up and improves the quality of life of the patient. Trial registration The study was approved by the Regional Bioethical Committee and conducted under the principles of the Helsinki Declaration and local laws and regulations.

BackgroundCoronary physiology-guided PCIs are recommended worldwide. However, invasive coronary physiology methods prolong the procedure, make additional risks for the patients, and prolong the uoroscopy time for an interventional cardiologist. Otherwise, there is a non-invasive coronary physiology evaluation method QFR, which can be safely used even in STEMI patients. Methods 198 patients admitted with STEMI and at least one intermediate (35-75%) diameter stenosis other than culprit artery between July 2020 and June 2021 have been prospectively included in this single-centre study. All patients were randomized into one of two groups (1 -QFR-guided PCI; 2 -visual-estimation-only guided PCI). A 12-month follow-up with echocardiography, exercise stress test, and quality of life evaluation was performed in all included patients. For the QOF evaluation, the Seattle angina score questionnaire was chosen. Statistical analysis was performed using Kolmogorov-Smirnov, Stjudent T, Mann-Whitney, Pearson Chi-square tests and Kaplan Meier survival analysis.Results 98 (49.5%) patients were randomized to the rst group, and 100 (50.5%) patients were included in the second group. Statistically, signi cantly more patients had a medical history of dyslipidaemia (98 vs 91, p = 0.002) and slightly better left ventricular ejection fraction (42.21 ± 7.88 vs 39.45 ± 9.62, p = 0.045) in the QFR group. Six times fewer patients required non-culprit artery revascularization within 12-month FU in the QFR group (1.02% vs 6%, p = 0.047). Survival analysis proved that patients in the Angio group had more than 6-time greater risk for death within a 12-month period after MI (OR 6.23,, p = 0.006), with the highest mortality risk within the rst two months after initial treatment. ConclusionsUsing QFR in non-culprit lesions for patients with ST-elevation myocardial infarction reduces mortality rate and revascularization in 12-month follow-up and increases the patient's quality of life. Trial registrationThe study was approved by the Regional Bioethical Committee and conducted under the principles of the Helsinki Declaration and local laws and regulations.

Background:Approximately half of the patients requiring percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) have additional stenotic coronary artery (CA) lesions in non-infarct-related arteries (non-IRA). This study from a single center in Lithuania aimed to evaluate the use of the quantitative flow ratio (QFR) in assessing non-IRA lesions during PCI in 79 patients diagnosed with STEMI. Material/Methods:We prospectively included 105 vessels of 79 patients with worldwide STEMI criteria and ³1 intermediate (35-75%) lesion in non-IRA between July 2020 and June 2021. For all included patients, QFR analyses were performed twice, during the index PCI (QFR 1) and during a staged procedure ³3 months later (QFR 2). The QFR analyses were performed with the QAngio-XA 3D and £0.80 were used as cut-off values for PCI. The primary endpoint was a head-to-head numerical agreement between 2 measurements. Results:An excellent numerical agreement was found in all investigated lesions, r=0.931, p<0.001, left anterior descending (LAD) r=0.911, p<0.001, left circumflex (LCx) r=0.977, p<0.001, and right coronary artery (RCA) 0.946, p<0.001. Clinical treatment decision-making showed amazing agreement between the 1 st and the 2 nd QFR analyses, r=0.980, p<0.001. There was 1 disagreement between QFR 1 and QFR 2. Conclusions:The findings from this support previous studies and showed that the QFR is a practical quantitative method to evaluate non-IRA lesions, which in this study included STEMI patients during PCI following occlusive CA stenosis.

Following publication of the original article [1], in this article "hospital of " has been removed in the first affiliation and the affiliation will read as follows:

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