Fractional Flow Reserve Versus Angiography for Guiding Selective Percutaneous Coronary Intervention in ST-segment Elevation Myocardial Infarction

Study Overview
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Brief Summary
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To assess the outcomes of patients with ST-segment elevation myocardial infarction (STEMI) assigned to fractional flow reserve (FFR) and angiography-guided selective percutaneous coronary intervention (PCI).

Detailed Description
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The investigators retrospectively collect STEMI patients received selective PCI from Jan 2012 to Dec 2015. Clinical follow-up is performed from the date of FFR assessment to Dec 2016 or death, which is up to 5 years. The primary endpoint is major adverse cardiac events, composite of cardiac death, reinfarction and unplanned hospitalization due to cardiovascular reasons. The primary endpoints are cardiac death, reinfarction and unplanned hospitalization due to cardiovascular reasons. All deaths are considered cardiovascular unless an unequivocal noncardiac cause could be established. Reinfarction is defined as myocardial infarction after the PCI procedure. Unplanned hospitalization will be present only if the patient is hospitalized unexpectedly because of persisting or increasing complaints of angina, ventricular arrhythmias and heart failure. All patients were received FFR-guided PCI or angiography-guided PCI before enrollment, and the investigators do not assign specific interventions to the subjects during the study. So this study might be considered to be observational.

Conditions
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Fractional Flow Reserve, ST-segment Elevation Myocardial Infarction, Percutaneous Coronary Intervention

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age>18 years documented acute ST-segment elevation myocardial infarction onset of symptom >6 days before percutaneous coronary intervention eligible for PCI Exclusion Criteria: cardiogenic shock or hemodynamic instability highly tortuous or calcified arteries infarct related artery with a diameter < 2.5mm a life expectancy< 2 years intolerance to anti-platelet drugs left main disease (≥ 50% stenosis) contraindication to adenosine hypertrophic cardiomyopathy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| FFR-PCI group<br>patients with ST-segment elevation myocardial infarction (STEMI) who received fractional flow reserve (FFR)-guided selective percutaneous coronary intervention (PCI) | |
| angiography-PCI group<br>patients with STEMI who received angiography-guided selective PCI | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major adverse cardiac events | composite of cardiac death, reinfarction and unplanned hospitalization due to cardiovascular reasons | up to 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cardiac death | All deaths are considered cardiovascular unless an unequivocal noncardiac cause could be established. | up to 5 years | 
| reinfarction | Reinfarction is defined as myocardial infarction after the PCI procedure. | up to 5 years | 
| unplanned hospitalization due to cardiovascular reasons | Unplanned hospitalization will be present only if the patient is hospitalized unexpectedly because of persisting or increasing complaints of angina, ventricular arrhythmias and heart failure. | up to 5 years |