biostudies-literatureUnknown17(4)Tang J<h4>Background</h4>Functional incomplete revascularisation (IR) is associated with a higher risk of major adverse cardiac events (MACE) during long-term follow-up in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).<h4>Aims</h4>This study aimed to investigate the prognostic ability of quantitative flow ratio (QFR)-guided residual functional SYNTAX score (Q-rFSS) and functional IR in STEMI patients undergoing PCI.<h4>Methods</h4>In total, 354 consecutive STEMI patients who successfully underwent PCI were included. Q-rFSS was defined as residual SYNTAX score (rSS) measured only in vessels with QFR ≤0.8. The primary outcome was MACE (a composite of all-cause mortality, myocardial infarction, and ischaemia-driven revascularisation) at 2 years.<h4>Results</h4>At two-year follow-up, functional IR (Q-rFSS ≥1) showed significantly higher risk for MACE than functional complete revascularisation (CR) (Q-rFSS=0) (functional IR vs CR, 22.0% vs 7.4%; hazard ratio [HR] 3.21; 95% confidence interval [Cl]: 1.74 to 5.91; p<0.001). The area under the curve (AUC) of Q-rFSS (0.738, 95% CI: 0.659 to 0.817) was significantly greater than that of rSS (0.648, 95% CI: 0.547 to 0.749). The C-statistic for MACE also increased after the addition of Q-rFSS to the clinical risk factors. Q-rFSS significantly improved risk classification compared with rSS (net reclassification improvement 0.439, 95% CI: 0.201 to 0.548; p<0.001).<h4>Conclusions</h4>Functional IR is associated with higher risk of MACE during long-term follow-up in STEMI patients undergoing PCI. Q-rFSS has a better prognostic ability for the risk of MACE.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiologye287-e293https://www.ebi.ac.uk/biostudies/studies/S-EPMC9724850biostudies-literatureQuantitative flow ratio-guided residual functional SYNTAX score for risk assessment in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.PMC9724850Liu XTang JLai YTu SYao YGao YGuan CChen FGu JChu JYang CYe ZfalseQuantitative flow ratio-guided residual functional SYNTAX score for risk assessment in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.<h4>Background</h4>Functional incomplete revascularisation (IR) is associated with a higher risk of major adverse cardiac events (MACE) during long-term follow-up in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).<h4>Aims</h4>This study aimed to investigate the prognostic ability of quantitative flow ratio (QFR)-guided residual functional SYNTAX score (Q-rFSS) and functional IR in STEMI patients undergoing PCI.<h4>Methods</h4>In total, 354 consecutive STEMI patients who successfully underwent PCI were included. Q-rFSS was defined as residual SYNTAX score (rSS) measured only in vessels with QFR ≤0.8. The primary outcome was MACE (a composite of all-cause mortality, myocardial infarction, and ischaemia-driven revascularisation) at 2 years.<h4>Results</h4>At two-year follow-up, functional IR (Q-rFSS ≥1) showed significantly higher risk for MACE than functional complete revascularisation (CR) (Q-rFSS=0) (functional IR vs CR, 22.0% vs 7.4%; hazard ratio [HR] 3.21; 95% confidence interval [Cl]: 1.74 to 5.91; p<0.001). The area under the curve (AUC) of Q-rFSS (0.738, 95% CI: 0.659 to 0.817) was significantly greater than that of rSS (0.648, 95% CI: 0.547 to 0.749). The C-statistic for MACE also increased after the addition of Q-rFSS to the clinical risk factors. Q-rFSS significantly improved risk classification compared with rSS (net reclassification improvement 0.439, 95% CI: 0.201 to 0.548; p<0.001).<h4>Conclusions</h4>Functional IR is associated with higher risk of MACE during long-term follow-up in STEMI patients undergoing PCI. Q-rFSS has a better prognostic ability for the risk of MACE.2021-01-01T00:00:00Z2021 Jul2025-04-05T15:43:49.948Z2025-04-05T15:43:49.948ZS-EPMC97248503158914510.4244/eij-d-19-0036910.4244/EIJ-D-19-00369