title: Fractional flow reserve of non-culprit vessel post-myocardial infarction: is it reliable?
abstract: BACKGROUND
  Multi-vessel disease is frequent in patients presenting with myocardial infarction and have an important prognostic impact. The decision to proceed to revascularization in non-culprit vessels can be postponed until ischemia is proven in non-invasive stress tests. On the other hand, there is an increasing evidence to support the role of fractional flow reserve (FFR) in acute coronary syndrome setting.
  
  
  METHODS
  We report a case in which a FFR-guided strategy for non-culprit vessels, 3 weeks after an ST-segment elevation myocardial infarction, was followed by a short-term sub-occlusion of the evaluated vessel.
  
  
  CONCLUSIONS
  The timing of the coronary microcirculation recovery post-myocardial infarction, avoiding a possible false negative FFR, and the diagnostic gaps between ischemia and plaque vulnerability are under discussion. An FFR-guided strategy in this setting should be interpreted with caution.
authors.affiliation: Departament of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, 3000-075, Portugal. luispcleite@gmail.com.
authors.forename: Luís
authors.initials: L
authors.lastname: Leite
authors.affiliation: Departament of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, 3000-075, Portugal. joanasofia.moura@gmail.com.
authors.forename: Joana
authors.initials: J
authors.lastname: Moura Ferreira
authors.affiliation: Departament of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, 3000-075, Portugal. silvamarques.j@gmail.com.
authors.forename: João
authors.initials: J
authors.lastname: Silva Marques
authors.affiliation: Departament of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, 3000-075, Portugal. elisabetejorge@gmail.com.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Jorge
authors.affiliation: Departament of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, 3000-075, Portugal. vazevedomatos@gmail.com.
authors.forename: Vítor
authors.initials: V
authors.lastname: Matos
authors.affiliation: Departament of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, 3000-075, Portugal. jobeguardado@gmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Guardado
authors.affiliation: Departament of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, 3000-075, Portugal. jocalisto@gmail.com.
authors.forename: João
authors.initials: J
authors.lastname: Calisto
authors.affiliation: Departament of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, 3000-075, Portugal. marianopego1@gmail.com.
authors.forename: Mariano
authors.initials: M
authors.lastname: Pego
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006439:Hemodynamics; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D062645:Percutaneous Coronary Intervention