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Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Joost Daemen received institutional grant/research support from Abbott Vascular, ACIST Medical, Boston Scientific, Medtronic, Microport, Pie Medical, and ReCor Medical, and consultancy and speaker fees from Abbott, Abiomed, ACIST medical, Boston Scientific, CardiacBooster, Cardialysis BV, Kaminari Medical, Medtronic, ReCor Medical, Pie Medical, PulseCath, and Siemens Health Care. Nicolas van Mieghem received institutional research grant support from Abbott Vascular, Biotronik, Boston Scientific, Daiichi Sankyo, Edwards Lifesciences, and Medtronic, and consultancy fees from Abbott, Abiomed, Amgen, Anteris, Boston Scientific, Daiichi Sankyo, JenaValve, Medtronic, PulseCath BV, and Teleflex. Tara Neleman has received institutional grant support from ACIST Medical Systems. The remaining authors report no relationships that could be construed as a conflict of interest.

Background: Thrombolysis in Myocardial Infarction (TIMI) 0 flow often characterizes ST-segment Elevation Myocardial Infarction (STEMI) patients, but may also feature in non-ST-segment Elevation Acute Coronary Syndrome (NSTE-ACS). Since recanalization usually occurs later in NSTE-ACS patients, the aim of this study was to assess whether patients presenting with NSTE-ACS and TIMI 0 flow have worse clinical outcomes as compared to patients presenting with STEMI and TIMI 0 flow., Methods: A single-center retrospective cohort study was conducted with patients treated for NSTE-ACS and STEMI with TIMI 0 flow at diagnostic angiogram between January 2015 and December 2019. The two patient groups were 1:1 matched using a propensity score logistic regression model. The primary outcome was Major Adverse Cardiac Events (MACE), a composite of all-cause mortality, any myocardial infarction, coronary artery bypass graft, urgent target vessel revascularization or stroke during long term follow-up., Results: The total population consisted of 1255 ACS patients, of which 249 NSTE-ACS and 1006 STEMI patients. After propensity score matching, 234 NSTE-ACS patients were matched with 234 STEMI patients. In this matched population, the mean age was 62.6 (±12.4) years and 75.2 % of the patients was male. The median follow-up time was 3.2 years. MACE rates during follow-up were similar between the two matched groups (HR = 0.84 [95 % CI 0.60 - 1.12] with p = 0.33) with cumulative event-free survival of 63.3 % in the NSTE-ACS group vs 59.3 % in the STEMI group at 6 year follow-up., Conclusion: In this retrospective study, a culprit lesion with TIMI 0 flow has similar clinical outcome in NSTE-ACS and STEMI patients. Further research is warranted to determine optimal the timing of PCI in NSTE-ACS patients with TIMI 0 flow., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background: Recently, non-hyperemic pressure ratios (NHPRs) have been validated as a reliable alternative to fractional flow reserve (FFR). However, a discordance between FFR and NHPRs is observed in 20-25% of cases. The aim of this study is to evaluate predictors of discordance between FFR and diastolic Pressure ratio (dPR)., Methods: PREDICT is a retrospective, single center, investigator-initiated study including 813 patients (1092vessels) who underwent FFR assessment of intermediate coronary lesions (angiographic 30%-80% stenosis). dPR was calculated using individual pressure waveforms and dedicated software. Clinical, angiographic and hemodynamic variables were compared between patients with concordant and discordant FFR and dPR values., Results: Median age was 65 (IQR:59-73) years and 70% were male. Hemodynamically significant lesions, as defined by FFR ≤ 0.80, and dPR ≤ 0.89, were identified in 29.6% and 30.3% of cases, respectively. Overall, FFR and dPR values were discordant in 22.1% patients (17.4% of the vessels). Discordance was related to FFR+/dPR- and FFR-/dPR + in 11.8% and 10.3% of patients, respectively.In case of FFR-dPR discordance, a higher prevalence of left anterior descending arteries lesions was observed (70.5% vs. 53.1%, p < 0.001) and mean values of both FFR and dPR were significantly lower (FFR 0.81 ± 0.05 vs 0.85 ± 0.08, p < 0.001, and dPR 0.89 ± 0.04 vs 0.92 ± 0.08,p < 0.001) as compared to vessels with FFR and dPR concordance. Following multivariable adjustment, dPR delta (defined as the absolute difference between measured dPR to the cut-off value of 0.89) turned out to be the only independent predictor of discordance (OR = 0.74, 95% CI 0.68-0.79, p < 0.001)., Conclusion: Our study suggests that FFR-to-dPR discordance occurs in approximately one-fifth of patients. Absolute dPR delta appears to be the only independent predictor of discordance., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper: [Conflicts of interest: Joost Daemen received institutional grant/research support from Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Microport, Pie Medical, and ReCor medical, and consultancy and speaker fees from Abbott Vascular, Abiomed, ACIST medical, Boston Scientific, Cardialysis BV, CardiacBooster, Kaminari Medical, ReCor Medical, PulseCath, Pie Medical, Sanofi, Siemens Health Care and Medtronic. Nicolas M. van Mieghem received research grant support from Abbott Vascular, Boston scientific, Biotronik, Edwards Lifesciences, Medtronic, Abiomed, PulseCath BV, Daiichi Sankyo. The other authors have no conflict of interest to declare.]., (© 2023 The Authors. Published by Elsevier B.V.)

Competing Interests: Nicolas Van Mieghem received institutional research grant support from Abbott Vascular, Abiomed, Boston Scientific, Daiichi-Sankyo, Edward Lifesciences, Medtronic, and PulseCath. Joost Daemen received institutional grant/research support from Abbott Vascular, ACIST Medical, Astra Zeneca, Boston Scientific, Medtronic, Microport, Pie Medical, and ReCor Medical, and consultancy and speaker fees from Abbott Vascular, Abiomed, ACIST medical, Boston Scientific, CardiacBooster, Cardialysis BV, Kaminari Medical, Medtronic, Pie Medical, PulseCath, ReCor Medical, Sanofi, and Siemens Health Care. The remaining authors report no relationships that could be construed as a conflict of interest.

Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.