{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:15:08Z","timestamp":1780546508204,"version":"3.54.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Fractional flow reserve (FFR)\u2010guided or angiography\u2010guided complete revascularization has not been evaluated in patients with acute myocardial infarction (AMI) with multivessel disease and reduced left ventricular ejection fraction (LVEF). This study sought to evaluate the impact of FFR\u2010guided percutaneous coronary intervention (PCI) for patients with AMI with multivessel disease according to left ventricular systolic function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We performed a prespecified analysis of the FRAME\u2010AMI (Fractional Flow Reserve Versus Angiography\u2010Guided Strategy in Acute Myocardial Infarction With Multivessel Disease) trial, which randomly allocated 562 patients to undergo either FFR\u2010guided PCI (FFR \u22640.80) or angiography\u2010guided PCI (diameter stenosis &gt;50%) for non\u2013infarct\u2010related arteries. Patients were classified into preserved (\u226550%) and reduced (&lt;50%) LVEF groups. Primary end point was major adverse cardiovascular events, a composite of death, myocardial infarction, and repeat revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Overall, 187 patients (33.3%) had reduced LVEF. During a median 3.5\u2010year follow\u2010up, patients with AMI with reduced LVEF showed an increased risk of major adverse cardiovascular events compared with those with preserved LVEF (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). FFR\u2010guided PCI for non\u2013infarct\u2010related arteries significantly reduced major adverse cardiovascular events among patients with preserved LVEF (3.3% versus 19.0%; hazard ratio [HR], 0.26 [95% CI, 0.11\u20130.66];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.004). Conversely, there was no significant difference in major adverse cardiovascular events between the FFR and angiography\u2010guided PCI among patients with reduced LVEF (17.0% versus 21.0%; HR, 0.64 [95% CI, 0.31\u20131.31];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.225). In the exploratory analysis, the clinical benefit of FFR\u2010guided PCI was more evident with an increased LVEF (interaction\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients with AMI with multivessel disease, FFR\u2010guided PCI for a non\u2013infarct\u2010related artery had differential clinical impact according to left ventricular systolic function. The beneficial effect of FFR\u2010guided PCI might be maximized among patients with preserved LVEF rather than reduced LVEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT02715518.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043414","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T11:07:15Z","timestamp":1756465635000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Relevance of Fractional Flow Reserve\u2010Guided Percutaneous Coronary Intervention According to Left Ventricular Ejection Fraction in Patients With Acute Myocardial Infarction and Multivessel Disease"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2337-7826","authenticated-orcid":false,"given":"Seung Hun","family":"Lee","sequence":"first","affiliation":[{"name":"Chonnam National University Hospital","place":["Gwangju, South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0261-3962","authenticated-orcid":false,"given":"Hangyul","family":"Kim","sequence":"additional","affiliation":[{"name":"Gyeongsang National University Hospital","place":["Jinju, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-4014","authenticated-orcid":false,"given":"Joo Myung","family":"Lee","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["Seoul, South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Ho","family":"Ahn","sequence":"additional","affiliation":[{"name":"Chonnam National University Hospital","place":["Gwangju, South 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Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0377-6352","authenticated-orcid":false,"given":"Kyung Hoo","family":"Cho","sequence":"additional","affiliation":[{"name":"Chonnam National University Hospital","place":["Gwangju, South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-1702","authenticated-orcid":false,"given":"Min Chul","family":"Kim","sequence":"additional","affiliation":[{"name":"Chonnam National University Hospital","place":["Gwangju, South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doo Sun","family":"Sim","sequence":"additional","affiliation":[{"name":"Chonnam National University Hospital","place":["Gwangju, South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4554-041X","authenticated-orcid":false,"given":"Hyun Kuk","family":"Kim","sequence":"additional","affiliation":[{"name":"University of Chosun College of Medicine","place":["Gwangju, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2303-4954","authenticated-orcid":false,"given":"Keun\u2010Ho","family":"Park","sequence":"additional","affiliation":[{"name":"University of Chosun College of Medicine","place":["Gwangju, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3166-3176","authenticated-orcid":false,"given":"Eun Ho","family":"Choo","sequence":"additional","affiliation":[{"name":"The Catholic University of Korea","place":["Seoul, South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan Joon","family":"Kim","sequence":"additional","affiliation":[{"name":"Uijeongbu St. Mary\u2019s Hospital","place":["Seoul, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1528-2739","authenticated-orcid":false,"given":"Sung Gyun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Wonju Severance Christian Hospital","place":["Wonju, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7966-9564","authenticated-orcid":false,"given":"Joon\u2010Hyung","family":"Doh","sequence":"additional","affiliation":[{"name":"Inje University Ilsan Paik Hospital","place":["Goyang, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1386-349X","authenticated-orcid":false,"given":"Sang Yeub","family":"Lee","sequence":"additional","affiliation":[{"name":"Chung\u2010Ang University Gwangmyeong Hospital","place":["Gwangmyeong, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0128-9988","authenticated-orcid":false,"given":"Sang Don","family":"Park","sequence":"additional","affiliation":[{"name":"Inha University Hospital","place":["Incheon, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1260-0778","authenticated-orcid":false,"given":"Hyun\u2010Jong","family":"Lee","sequence":"additional","affiliation":[{"name":"Sejong General Hospital","place":["Bucheon, Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9672-1798","authenticated-orcid":false,"given":"Min Gyu","family":"Kang","sequence":"additional","affiliation":[{"name":"Gyeongsang National University Hospital","place":["Jinju, 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