Angio‐based coronary functional assessment predicts 30‐day new‐onset heart failure after acute myocardial infarction

Aims Suboptimal perfusion leading to heart failure (HF) often occurs after ST‐segment elevation myocardial infarction (STEMI), despite restoration of epicardial coronary flow in primary percutaneous coronary intervention (PPCI) era. We determined the clinical implications of angio‐based coronary functional assessment in evaluation of suboptimal perfusion and further outcomes among STEMI patients after successful PPCI. Methods and results In this study, STEMI patients in the Chinese STEMI PPCI registry trial (NCT04996901) who achieved post‐PPCI thrombolysis in myocardial infarction grade 3 flow were retrospectively screened. Post‐procedural quantitative flow ratio (QFR), angio‐based microvascular resistance (AMR), and coronary flow velocity (CFV) of the infarct‐related artery were calculated. QFR and AMR measure epicardial stenosis severity and microvascular resistance, respectively. QFR+ was defined as QFR