{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:57:11Z","timestamp":1767182231060,"version":"3.41.2"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":42,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["214567\/Z\/18\/Z"],"award-info":[{"award-number":["214567\/Z\/18\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["TG\/19\/1\/3445"],"award-info":[{"award-number":["TG\/19\/1\/3445"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["II-LB-0216-20006"],"award-info":[{"award-number":["II-LB-0216-20006"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022572","name":"NIHR Sheffield Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203321"],"award-info":[{"award-number":["NIHR203321"]}],"id":[{"id":"10.13039\/501100022572","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]},{"name":"VIRTUheart"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>In the complete revascularization with multivessel PCI for myocardial infarction (COMPLETE) trial, staged complete revascularization in patients with ST-segment-elevation myocardial infarction (MI) reduced major adverse cardiovascular events compared with culprit-only revascularization. Inclusion was based on angiographic criteria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We modelled non-culprit virtual fractional flow reserve (vFFR) and investigated interactions between physiological lesion severity and the benefits of complete revascularization in COMPLETE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>All suitable angiograms from COMPLETE underwent software-based 3-dimensional (3D) arterial reconstruction and analysis of 3D-quantitative coronary angiography (QCA) and vFFR using computational fluid dynamics software. Physiological lesion significance was defined as vFFR \u22640.80 and was compared with operators\u2019 visual angiographic analysis, 2D-QCA and 3D-QCA. vFFR was computed in 635 patients (710 lesions). 302 patients (48%) had \u22651 physiologically significant lesion and 333 (52%) had none. 321 (45%) lesions were physiologically significant and 389 (55%) were not. There was no statistically significant interaction between physiological lesion significance and any of the trial co-primary or key secondary clinical outcomes, or an exploratory outcome of ischaemia-driven revascularization without preceding MI (all interaction P &amp;gt; 0.30). 3D-QCA predicted vFFR significance more accurately than visual and 2D-QCA (concordance 73% vs. 49% vs. 59%, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this virtual physiological substudy of the COMPLETE trial, 52% of patients lacked any physiologically significant lesions and the benefits of complete revascularization appeared to be independent of physiological lesion significance. 3D-QCA was a better predictor of physiological significance than either 2D-QCA or operator visual analysis. Further research is warranted to compare angiography-guided and physiology-guided complete revascularization strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeaf057","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T07:24:12Z","timestamp":1749626652000},"source":"Crossref","is-referenced-by-count":2,"title":["Virtual physiological analysis of non-culprit disease in patients with STEMI and multivessel disease: a substudy of the COMPLETE trial"],"prefix":"10.1093","volume":"5","author":[{"given":"Gareth J","family":"Williams","sequence":"first","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3270-6708","authenticated-orcid":false,"given":"Daniel J","family":"Taylor","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]},{"name":"NIHR Sheffield Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]},{"name":"Insigneo Institute for in Silico Medicine , Mappin Street, Sheffield S1 3JD ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulaziz","family":"Al Baraikan","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]},{"name":"College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences , Prince Mutib Ibn Abdullah Ibn Abdulaziz Road, Riyadh ,","place":["Saudi 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Medicine and Population Health, University of Sheffield , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]},{"name":"Faculty of Life Sciences and Medicine, King\u2019s College London , Great Maze Pond, London SE1 1UL ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Anigboro","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vignesh","family":"Rammohan","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7465-3563","authenticated-orcid":false,"given":"Rebecca","family":"Gosling","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]},{"name":"NIHR Sheffield Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]},{"name":"Insigneo Institute for in Silico Medicine , Mappin Street, Sheffield S1 3JD ,","place":["UK"]},{"name":"South Yorkshire Cardiothoracic Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road , Sheffield S5 7AU ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Newman","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population 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Main Street West, Hamilton, Ontario , L8S 4L8","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-6229","authenticated-orcid":false,"given":"Robert F","family":"Storey","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]},{"name":"NIHR Sheffield Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust , Beech Hill Road, Sheffield S10 2RX ,","place":["UK"]},{"name":"Insigneo Institute for in Silico Medicine , Mappin Street, Sheffield S1 3JD ,","place":["UK"]},{"name":"South Yorkshire Cardiothoracic Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road , Sheffield S5 7AU ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian P","family":"Gunn","sequence":"additional","affiliation":[{"name":"Division of 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