Functional or anatomical assessment of non-culprit lesions in acute myocardial infarction
Authors' conclusion
When 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.
Study context
- Population
- Acute myocardial infarction (AMI) patients with intermediate non-culprit lesions in non-infarct-related arteriesAMI patients, 1,320 intermediate non-culprit lesions (NCLs)
- Participants
- 645 patients
- Comparison
- Acute Murray fractal law-based quantitative flow ratio (QFR) values and OCT-defined thin-cap fibroatheroma (TCFA)
- Outcome
- Composite of:
- Cardiac death
- NCL-related non-fatal myocardial infarction (MI)
- NCL-related unplanned coronary revascularisation
- Follow-up
- Lasting up to 5 years
Main finding
As reported in the abstract
OCT-defined TCFAAdjusted hazard ratio (95% CI)
Patient-level
3.05(1.80–5.19)
NCL-specific
4.46(2.33–8.56)
- Primary endpoint occurred in patients
- 59 patients (11.1%)
Further findings
Primary endpoint by AMI type (subgroup)
| Adjusted HR (95% CI) | ||
|---|---|---|
| TCFASTEMI | 3.27 (1.67–6.41) | |
| TCFAnon-STEMI | 3.26 (1.24–8.54) | |
| 0.10.31310Adjusted hazard ratio (log scale) |
- μQFR ≤0.80 was not an independent predictor
Original publication
Functional or anatomical assessment of non-culprit lesions in acute myocardial infarction. EuroIntervention. Published 17 February 2025. doi:10.
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