{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T02:38:44Z","timestamp":1782873524297,"version":"3.54.5"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients with ST\u2010segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease, the optimal management strategy for non\u2010culprit lesions is a subject of ongoing debate. There has been an increasing use of physiology\u2010guidance to assess the extent of occlusion in non\u2010culprit lesions, and hence the need for stenting. Fractional flow reserve (FFR) is commonly used as a technique. This analysis compares FFR versus conservative management in the management of non\u2010culprit lesions in STEMI patients with multivessel disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive literature search was conducted on databases from inception to May 25, 2024. We conducted a random\u2010effects meta\u2010analysis using RevMan version 5.3.0, employing the Der\u2010Simonian and Laird method to combine the data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis of five RCTs including 3759 patients revealed a significantly lower incidence of major adverse cardiovascular events (composite of all\u2010cause mortality, non\u2010fatal myocardial infarction and the need for repeat revascularization [PCI or CABG]) in the FFR group compared to the conservative management group (RR\u2009=\u20090.65, 95% CI: 0.44\u22120.96, <jats:italic>p<\/jats:italic>\u2009=\u20090.03). The revascularization rates were significantly lower in the FFR group (RR\u2009=\u20090.53, 95% CI: 0.43\u22120.66, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00001). Additionally, unplanned hospitalization leading to urgent repeat revascularization and any cause hospitalization were significantly lower in the FFR group (RR\u2009=\u20090.72, 95% CI: 0.56\u22120.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), and (RR\u2009=\u20090.62, 95% CI: 0.46\u22120.84, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), respectively. The FFR group had a higher risk of definite stent thrombosis (RR\u2009=\u20092.26, 95% CI: 1.10\u22124.64, <jats:italic>p<\/jats:italic>\u2009=\u20090.03). No significant differences were observed between the two groups in mortality, hospitalization for heart failure, or myocardial infarction. Similarly, bleeding rates, cerebrovascular accidents (CVAs), and contrast\u2010induced nephropathy (CIN) were comparable between both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings support FFR\u2010guided PCI to manage non\u2010culprit lesions in STEMI patients with multivessel disease as it is potentially safe, with comparable rates of bleeding, CVAs and CIN. It also improves clinical outcomes, as well as reduces revascularization and hospitalization rates. The risk of stent thrombosis remains a concern, and hence the decision making for FFR\u2010guided complete revascularization should take into account the complexity\/risk of the procedure, as well as the patients' individual co\u2010morbidities and preferences.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31379","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T07:15:27Z","timestamp":1735024527000},"page":"633-642","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparing FFR\u2010Guided Complete Revascularization and Conservative Management for Non\u2010Culprit Lesions in STEMI Patients With Multivessel Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8946-9904","authenticated-orcid":false,"given":"Ahmed R.","family":"Gonnah","sequence":"first","affiliation":[{"name":"Department of Medicine 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University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0787-5830","authenticated-orcid":false,"given":"Aser","family":"Labib","sequence":"additional","affiliation":[{"name":"Department of Medicine Northern Lincolnshire and Goole Hospitals NHS Foundation Trust Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein","family":"Saoudy","sequence":"additional","affiliation":[{"name":"Department of Medicine Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman K.","family":"Awad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Galala University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Lancashire Cardiac Centre Blackpool UK"},{"name":"School of Medicine University of 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