PCI for Nonculprit Lesions in Patients with STEMI — No Role for FFR

Approximately 50% of patients with acute ST-segment elevation myocardial infarction (STEMI) have multivessel disease.1 For such patients, a major clinical question has been whether percutaneous coronary intervention (PCI) should be performed only on the coronary occlusion causing the infarct (the culprit lesion) or whether other stenoses (nonculprit lesions) should also be treated during, or soon after, the culprit-lesion procedure. Seven small or midsize trials involving a total of 1939 patients with STEMI that were published through 2015 suggested that early PCI of nonculprit lesions was associated with a lower risk of major adverse cardiac events than culprit-lesion-only PCI, driven by . . .