Related Experiment Video

Updated: Feb 16, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

26.4K

FFR-guided multivessel stenting reduces urgent revascularization compared with infarct-related artery only stenting

Ankur Gupta1, Navkaranbir S Bajaj1, Pankaj Arora2

  • 1Heart and Vascular Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

International Journal of Cardiology
|December 19, 2017
PubMed

Insights

Fractional flow reserve-guided (FFR) multivessel stenting significantly reduces repeat revascularization in ST-elevation myocardial infarction (STEMI) patients. This strategy also lowers urgent revascularization rates, though its impact on reinfarction requires further study.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • ST-elevation myocardial infarction (STEMI) with multivessel disease presents treatment challenges.
  • Fractional flow reserve (FFR)-guided multivessel stenting has shown superiority over infarct-related artery (IRA)-only stenting.
  • Previous trials were underpowered to assess urgent revascularization or reinfarction outcomes.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials (RCTs).
  • To evaluate the efficacy of FFR-guided multivessel stenting versus IRA-only stenting in STEMI patients.
  • To assess the impact on death, reinfarction, and urgent/non-urgent repeat revascularization.

Main Methods:

  • Searched major databases (PubMed, EMBASE, Cochrane CENTRAL, Web of Science) for relevant RCTs.
  • Included 2 RCTs comparing FFR-guided multivessel stenting with IRA-only stenting in STEMI patients.
  • Pooled risk ratios (RR) using a random-effects model to determine outcomes.

Main Results:

  • FFR-guided multivessel stenting significantly reduced the composite of death, reinfarction, or revascularization (RR: 0.49).
  • This reduction was primarily driven by decreased urgent (RR: 0.41) and non-urgent (RR: 0.31) repeat revascularization.
  • While reinfarction rates were lower with FFR guidance, the difference was not statistically significant (RR: 0.71).

Conclusions:

  • FFR-guided multivessel stenting is effective in reducing overall and urgent repeat revascularization in STEMI patients.
  • The strategy demonstrates a favorable trend towards reduced reinfarction.
  • Larger trials are needed to definitively assess the effect of FFR-guided stenting on reinfarction rates.
Abstract

Keywords:
FFRMeta-analysisMultivesselPCISTEMIStenting

More Related Videos

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis06:59

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

Published on: August 26, 2025

620
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

12.3K

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.1K
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
309
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
307
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
459
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
374
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
294