title: Results of fractional flow reserve measurement to evaluate nonculprit coronary artery stenoses in patients with acute coronary syndrome.
abstract: OBJECTIVE
  Multivessel disease is usually present in almost half of patients with acute coronary syndromes. Angiography is insufficiently accurate to decide on coronary revascularization in moderate nonculprit lesions. There is some debate about the usefulness of fractional flow reserve assessed by intracoronary pressure wire in acute coronary syndromes. We studied the results of using fractional flow reserve values to decide whether to perform coronary revascularization of nonculprit angiographically moderate lesions in patients with acute coronary syndrome and multivessel disease.
  
  
  METHODS
  The fractional flow reserve was used to decide whether to revascularize angiographically moderate nonculprit lesions in a cohort of consecutive patients with acute coronary syndromes recruited in 2 centers.
  
  
  RESULTS
  One hundred and seven patients were included. Based on fractional flow reserve values, 81 patients (75.7%) were not revascularized. All lesions studied were revascularized in 26 patients (24.3%). Patient characteristics of the nontreated group and treated group were, respectively, diseased vessels, 1.3 (0.7) vs 1.4 (0.6) (P<.4); fractional flow reserve-studied lesions, 1.2 (0.5) vs 1.1 (0.4) (P=.3); stenosis, 46.1 (8.3)% vs 47.9 (10.3)% (P=.4); fractional flow reserve, 0.86 (0.1) vs 0.70 (0.1) (P<.005). After 1 year of follow-up, no significant differences in major cardiovascular events were observed between groups. There no deaths or nonfatal myocardial infarctions attributable to fractional flow reserve -deferred lesions. Coronary revascularization of the studied lesions was performed in 3 nontreated group patients (3.7%) due to disease progression.
  
  
  CONCLUSIONS
  Fractional flow reserve assessed by intracoronary pressure wire is useful in deciding whether to revascularize angiographically moderate nonculprit lesions in patients with acute coronary syndrome and multivessel disease.
authors.affiliation: Unidad de Hemodinámica, Sección de Cardiología, Hospital Universitario, San Juan de Alicante, Alicante, Spain. mlopezs@meditex.es
authors.forename: Ramón
authors.initials: R
authors.lastname: Lopez-Palop
authors.forename: Pilar
authors.initials: P
authors.lastname: Carrillo
authors.forename: Francisco
authors.initials: F
authors.lastname: Torres
authors.forename: Iñigo
authors.initials: I
authors.lastname: Lozano
authors.forename: Araceli
authors.initials: A
authors.lastname: Frutos
authors.forename: Pablo
authors.initials: P
authors.lastname: Avanzas
authors.forename: Alberto
authors.initials: A
authors.lastname: Cordero
authors.forename: Juan
authors.initials: J
authors.lastname: Rondán
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D016019:Survival Analysis; D016276:Ventricular Function