{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:28:58Z","timestamp":1787502538661,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">In ST\u2010segment\u2013elevation myocardial infarction, angiography\u2010based complete revascularization is superior to culprit\u2010lesion\u2010only percutaneous coronary intervention. Quantitative flow ratio (QFR) is a novel, noninvasive, vasodilator\u2010free method used to assess the hemodynamic significance of coronary stenoses. We aimed to investigate the incremental value of QFR over angiography in nonculprit lesions in patients with ST\u2010segment\u2013elevation myocardial infarction undergoing angiography\u2010guided complete revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This was a retrospective post hoc QFR analysis of untreated nontarget vessels (any degree of diameter stenosis [DS]) from the randomized multicenter COMFORTABLE AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST\u2010Elevation Myocardial Infarction) trial by assessors blinded for clinical outcomes. The primary end point was cardiac death, spontaneous nontarget vessel myocardial infarction, and clinically indicated nontarget vessel revascularization (ie, \u226570% DS by 2\u2010dimensional quantitative coronary angiography or \u226550% DS and ischemia) at 5\u00a0years. Of 1161 patients with ST\u2010segment\u2013elevation myocardial infarction, 946 vessels in 617 patients were analyzable by QFR. At 5\u00a0years, the rate of the primary end point was significantly higher in patients with QFR \u22640.80 (n=35 patients, n=36 vessels) versus QFR &gt;0.80 (n=582 patients, n=910 vessels) (62.9% versus 12.5%, respectively; hazard ratio [HR], 7.33 [95% CI, 4.54\u201311.83],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), driven by higher rates of nontarget vessel myocardial infarction (12.8% versus 3.1%, respectively; HR, 4.38 [95% CI, 1.47\u201313.02],\n                      <jats:italic>P<\/jats:italic>\n                      =0.008) and nontarget vessel revascularization (58.6% versus 7.7%, respectively; HR, 10.99 [95% CI, 6.39\u201318.91],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) with no significant differences for cardiac death. Multivariable analysis identified QFR \u22640.80 but not \u226550% DS by 3\u2010dimensional quantitative coronary angiography as an independent predictor of the primary end point. Results were consistent, including only &gt;30% DS by 3\u2010dimensional quantitative coronary angiography.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Our study suggests incremental value of QFR over angiography\u2010guided percutaneous coronary intervention for nonculprit lesions among patients with ST\u2010segment\u2013elevation myocardial infarction undergoing primary percutaneous coronary intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.019052","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T05:53:51Z","timestamp":1619416431000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Quantitative Flow Ratio to Predict Nontarget Vessel\u2013Related Events at 5 Years in Patients With ST\u2010Segment\u2013Elevation Myocardial Infarction Undergoing Angiography\u2010Guided Revascularization"],"prefix":"10.1161","volume":"10","author":[{"given":"Sarah","family":"B\u00e4r","sequence":"first","affiliation":[{"name":"Department of Cardiology Bern University Hospital Inselspital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raminta","family":"Kavaliauskaite","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bern University Hospital Inselspital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bern University Hospital Inselspital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuhiko","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bern University Hospital Inselspital Bern 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University Hospital Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"von Birgelen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Thoraxcentrum Medisch Spectrum Twente Enschede the Netherlands"},{"name":"Department of Health Technology and Services Research Technical Medical Centre University of Twente Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miodrag","family":"Ostojic","sequence":"additional","affiliation":[{"name":"Medical School University of Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pedrazzini","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiocentro Ticino Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Kornowski","sequence":"additional","affiliation":[{"name":"Cardiology Department Rabin Medical Center Tel Aviv University Petah Tikwa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"T\u00fcller","sequence":"additional","affiliation":[{"name":"Cardiology Department Triemlispital Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladan","family":"Vukcevic","sequence":"additional","affiliation":[{"name":"Medical School University of Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Magro","sequence":"additional","affiliation":[{"name":"TweeSteden Ziekenhuis Tilburg the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Losdat","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit (CTU) Bern University of Bern 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