黑料福利网

Each year, more than 30,000 people in the Netherlands are hospitalized with an acute myocardial infarction (heart attack), and over half present with multivessel coronary artery disease. While the infarct-related artery (culprit lesion) is treated immediately, the assessment and treatment of additional lesions vary substantially between hospitals.

Current European Society of Cardiology guidelines recommend a strategy of complete revascularization, in which all clinically significant lesions are assessed and treated during the index hospitalization or within 45 days of the myocardial infarction. Although multiple studies have demonstrated improved clinical outcomes and reduced healthcare utilization with this approach, complete revascularization is not yet consistently implemented in routine clinical practice.

A key barrier is the assessment of non-culprit lesions. Angiography-derived fractional flow reserve (angio-FFR) is an innovative technology that uses routine coronary angiograms and computational modelling to determine whether a coronary stenosis impairs blood flow, without the need for additional invasive measurements. Despite its potential to simplify and accelerate clinical decision-making, angio-FFR has not yet been widely adopted in the Netherlands.

This multicentre implementation study, coordinated by Catharina Hospital Eindhoven, aims to increase the use of both angio-FFR and complete revascularization across Dutch hospitals. Using data from participating centres and the Netherlands Heart Registration, we will evaluate how these evidence-based strategies can be successfully integrated into daily clinical practice and assess their impact on patient outcomes, care pathways, and healthcare costs.

Huub Lucas Luijckx