Prognostic Value of Plaque Radial Wall Strain Analysis in Patients With Acute Myocardial Infarction After Complete Revascularization

BACKGROUND: Even after complete revascularization (CR), patients with acute myocardial infarction (AMI) still face significant risks of adverse events, frequently linked to vulnerable plaque progression in nonsignificant stenosis. AIMS: To investigate the relationship between the radial wall strain (RWS) of nonsignificant stenosis lesions and major adverse cardiac events (MACE) in patients with AMI following CR. METHODS: This cohort study included patients with AMI who received CR of all culprit and non-culprit lesions with diameter stenosis (DS%) > 70% during index or staged percutaneous coronary intervention within 45 days, with at least one de novo native lesion (DS% of 30%-70%) for RWS analysis. The primary outcome was MACE comprising cardiovascular death, nonfatal myocardial infarction, unstable angina, and heart failure. RESULTS: on MACE was comparable to that observed in patients with μQFR < 0.8 (P for interaction = 0.236). CONCLUSIONS: Among patients with AMI who received CR, a high-strain pattern detected by RWS analysis in nonsignificant stenosis lesions was associated with a worse clinical outcome.