2024
Percutaneous Coronary Revascularization Strategies After Myocardial Infarction A Systematic Review and Network Meta-Analysis
Reddy R, Howard J, Jamil Y, Madhavan M, Nanna M, Lansky A, Leon M, Ahmad Y. Percutaneous Coronary Revascularization Strategies After Myocardial Infarction A Systematic Review and Network Meta-Analysis. Journal Of The American College Of Cardiology 2024, 84: 276-294. PMID: 38986670, DOI: 10.1016/j.jacc.2024.04.051.Peer-Reviewed Original ResearchConceptsRelative riskCardiovascular mortalityMyocardial infarctionMultivessel coronary artery diseaseAll-cause mortalityAdverse cardiac eventsST-segment elevation myocardial infarctionComplete revascularizationCoronary artery diseaseBayesian network meta-analysesMortality reductionA systematic reviewNetwork meta-analysesElevation myocardial infarctionSystematic reviewMeta-analysesCardiac eventsArtery diseasePrimary outcomeNetwork meta-analysisRevascularization strategyMeta-analysisHead-to-head trialsCoronary revascularization strategyAcute kidney injuryFrailty and In-Hospital Outcomes for Management of Cardiogenic Shock without Acute Myocardial Infarction
Park D, Jamil Y, Ahmad Y, Coles T, Bosworth H, Sikand N, Davila C, Babapour G, Damluji A, Rao S, Nanna M, Samsky M. Frailty and In-Hospital Outcomes for Management of Cardiogenic Shock without Acute Myocardial Infarction. Journal Of Clinical Medicine 2024, 13: 2078. PMID: 38610842, PMCID: PMC11012362, DOI: 10.3390/jcm13072078.Peer-Reviewed Original ResearchDo-not-resuscitate statusOdds of in-hospital mortalitySkilled nursing facilityIn-hospital adverse eventsRelationship of frailtyCompare in-hospital outcomesNon-frail groupRisk score cut-offNational Inpatient SampleAssociated with increased rates of morbidityNursing facilitiesMyocardial infarctionAssociated with increased ratesFrail adultsIn-hospital mortalityIn-hospital outcomesAcute myocardial infarctionFrail groupScore cut-offFrailtyInpatient SampleCardiogenic shockRisk factorsCardiovascular diseaseHospitalIntravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis
Stone G, Christiansen E, Ali Z, Andreasen L, Maehara A, Ahmad Y, Landmesser U, Holm N. Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis. The Lancet 2024, 403: 824-837. PMID: 38401549, DOI: 10.1016/s0140-6736(23)02454-6.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionIntravascular imaging guidanceTarget vessel myocardial infarctionIntravascular imaging-guided percutaneous coronary interventionAngiography-guided percutaneous coronary interventionImaging-guided percutaneous coronary interventionOptical coherence tomographyAngiography guidanceTarget lesion revascularisationImage guidanceMeta-analysisTarget lesion failureInternational Prospective Register of Systematic ReviewsSystematic reviewProspective Register of Systematic ReviewsMyocardial infarctionDrug-eluting stentsCardiac deathInternational Prospective RegisterLesion failureStent thrombosisRisk of cardiac deathRisk of target lesion failureStudy-level dataIntravascular ultrasound-guided percutaneous coronary intervention
2023
The association of timing of coronary artery bypass grafting for non-ST-elevation myocardial infarction and clinical outcomes in the contemporary United States
Park D, Singireddy S, Mangalesh S, Fishman E, Ambrosini A, Jamil Y, Vij A, Sikand N, Ahmad Y, Frampton J, Nanna M. The association of timing of coronary artery bypass grafting for non-ST-elevation myocardial infarction and clinical outcomes in the contemporary United States. Coronary Artery Disease 2023, 35: 261-269. PMID: 38164979, PMCID: PMC11042982, DOI: 10.1097/mca.0000000000001314.Peer-Reviewed Original ResearchLength of stayCoronary artery bypassElevation myocardial infarctionNSTEMI hospitalizationsHospital mortalityArtery bypassCABG surgeryMyocardial infarctionHigher oddsLonger LOSBurden of complicationsHospital-associated costsNon-home dischargeAcute kidney injuryHigh-risk featuresPercutaneous coronary interventionAssociation of timingOutcomes of interestNSTEMI populationGastrointestinal hemorrhageHospital outcomesKidney injuryPerioperative complicationsCoronary interventionBlood transfusionCatheter ablation for ventricular tachycardia after myocardial infarction: meta-analysis of randomised controlled trials
Reddy R, Howard J, Ahmad Y, Shun-Shin M, Simader F, Miyazawa A, Saleh K, Samways J, Keene D, Linton N, Francis D, Whinnett Z, Luther V, Kanagaratnam P, Arnold A. Catheter ablation for ventricular tachycardia after myocardial infarction: meta-analysis of randomised controlled trials. European Heart Journal 2023, 44: ehad655.392. DOI: 10.1093/eurheartj/ehad655.392.Peer-Reviewed Original ResearchIndividual patient dataReconstructed individual patient dataPrior myocardial infarctionCatheter ablationMedical therapyMyocardial infarctionCause mortalityVT recurrenceDefibrillator shocksVentricular tachycardiaPatient dataCox proportional hazards regression modelPost-infarct ventricular tachycardiaPre-specified primary endpointPre-specified secondary endpointsVentricular tachycardia catheter ablationProportional hazards regression modelsResults Eight trialsProportion of patientsKaplan-Meier curvesHazards regression modelsCause hospitalisationPrimary endpointSecondary endpointsPrognostic impactLong-term Incidence of Myocardial Infarction and Death After CABG and PCI for Isolated Left Anterior Descending Artery Disease: A Meta-analysis of Randomized Controlled Trials
Prasad M, Ahmad Y, Howard J, Ben-Ami J, Madhavan M, Kirtane A, McEntegart M, Flattery E, Stone G, Leon M, Moses J. Long-term Incidence of Myocardial Infarction and Death After CABG and PCI for Isolated Left Anterior Descending Artery Disease: A Meta-analysis of Randomized Controlled Trials. Journal Of The Society For Cardiovascular Angiography & Interventions 2023, 2: 100636. DOI: 10.1016/j.jscai.2023.100636.Peer-Reviewed Original ResearchPercutaneous coronary interventionLong-term incidenceMyocardial infarctionLAD diseaseArtery diseaseLeft anterior descending (LAD) coronary artery diseaseAnterior descending (LAD) coronary artery diseaseLeft internal mammary artery graftInternal mammary artery graftRisk of MIMammary artery graftsCoronary artery bypassCoronary artery diseaseRandomized Controlled TrialsSignificant differencesArtery bypassArtery graftCause mortalityVessel revascularizationCoronary interventionSecondary outcomesControlled TrialsLeft anteriorPrimary outcomeCABGDeferred Versus Performed Revascularization for Left Main Coronary Disease With Hemodynamic Significance
Warisawa T, Cook C, Ahmad Y, Howard J, Seligman H, Rajkumar C, Toya T, Doi S, Nakajima A, Nakayama M, Vera-Urquiza R, Yuasa S, Sato T, Kikuta Y, Kawase Y, Nishina H, Al-Lamee R, Sen S, Lerman A, Matsuo H, Akashi Y, Escaned J, Davies J. Deferred Versus Performed Revascularization for Left Main Coronary Disease With Hemodynamic Significance. Circulation Cardiovascular Interventions 2023, 16: e012700. PMID: 37339234, DOI: 10.1161/circinterventions.122.012700.Peer-Reviewed Original ResearchConceptsIschemia-driven target lesion revascularizationTarget lesion revascularizationLeft main stemCoronary artery diseaseStable coronary artery diseaseLong-term clinical outcomesPrimary end pointSecondary end pointsInstantaneous wave-free ratioLesion revascularizationArtery diseaseClinical outcomesMyocardial infarctionEnd pointRevascularization deferralCardiac deathLeft main coronary diseaseMain coronary artery diseaseBaseline clinical characteristicsComposite of deathContemporary clinical outcomesInternational multicenter registryMain coronary diseaseNonfatal myocardial infarctionMedian followPhysiology-guided PCI versus CABG for left main coronary artery disease: insights from the DEFINE-LM registry
Warisawa T, Cook C, Kawase Y, Howard J, Ahmad Y, Seligman H, Rajkumar C, Toya T, Doi S, Nakajima A, Tanigaki T, Omori H, Nakayama M, Vera-Urquiza R, Yuasa S, Sato T, Kikuta Y, Nishina H, Al-Lamee R, Sen S, Lerman A, Akashi Y, Escaned J, Matsuo H, Davies J. Physiology-guided PCI versus CABG for left main coronary artery disease: insights from the DEFINE-LM registry. Cardiovascular Intervention And Therapeutics 2023, 38: 287-298. PMID: 37017899, PMCID: PMC10247826, DOI: 10.1007/s12928-023-00932-z.Peer-Reviewed Original ResearchConceptsUnprotected left main coronary diseasePercutaneous coronary interventionInstantaneous wave-free ratioMain coronary artery diseaseNon-fatal myocardial infarctionCoronary artery bypassCoronary artery diseasePrimary endpointCause deathLesion revascularizationArtery bypassSYNTAX scoreCoronary interventionArtery diseaseClinical outcomesMyocardial infarctionIschemia-driven target lesion revascularizationLeft main coronary artery diseaseArt percutaneous coronary interventionLeft main coronary diseaseLower cardiovascular event ratesMajor adverse cardiovascular eventsLong-term clinical outcomesPropensity scorePhysiology-guided percutaneous coronary intervention
2022
Meta-Analysis of Provisional Versus Systematic Double-Stenting Strategy for Left Main Bifurcation Lesions
Abdelfattah OM, Radwan A, Sayed A, Elbadawi A, Derbas LA, Saleh Y, Ahmad Y, ElJack A, Masoumi A, Karmpaliotis D, Elgendy IY, Alfonso F. Meta-Analysis of Provisional Versus Systematic Double-Stenting Strategy for Left Main Bifurcation Lesions. Cardiovascular Revascularization Medicine 2022, 45: 53-62. PMID: 35934644, DOI: 10.1016/j.carrev.2022.07.017.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsTarget lesion revascularizationPercutaneous coronary interventionBifurcation percutaneous coronary interventionSecond generation drug eluting stentsDrug eluting stentsDouble-stent strategyMyocardial infarctionObservational studyLesion revascularizationCause mortalityCardiovascular mortalityDouble stentingStent thrombosisProvisional stentingLower major adverse cardiovascular eventsInternational Clinical Trials Registry PlatformClinical Trials Registry PlatformMain bifurcation lesionsAdverse cardiovascular eventsCochrane Central RegisterTrials Registry PlatformSignificant lower rateProvisional stenting strategyCardiovascular events
2021
Long-term follow-up after ultrathin vs. conventional 2nd-generation drug-eluting stents: a systematic review and meta-analysis of randomized controlled trials
Madhavan MV, Howard JP, Naqvi A, Ben-Yehuda O, Redfors B, Prasad M, Shahim B, Leon MB, Bangalore S, Stone GW, Ahmad Y. Long-term follow-up after ultrathin vs. conventional 2nd-generation drug-eluting stents: a systematic review and meta-analysis of randomized controlled trials. European Heart Journal 2021, 42: 2643-2654. PMID: 34002202, PMCID: PMC8282325, DOI: 10.1093/eurheartj/ehab280.Peer-Reviewed Original ResearchConceptsThin-strut drug-eluting stentsUltrathin-strut drug-eluting stentsTarget lesion failureDrug-eluting stentsStent thrombosisMyocardial infarctionCardiac deathCause mortalityCD-TLRRisk of TLFSystematic reviewPre-specified primary endpointRisk of MIRevascularization of patientsWeighted mean followTarget lesion revascularizationPercutaneous coronary interventionStandard of careNew trial dataCause deathLesion revascularizationEligible trialsLesion failureMean followPrimary endpointSingle Versus Dual Antiplatelet Therapy After Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized Clinical Trials
Ahmad Y, Howard JP, Madhavan MV, Leon MB, Makkar RR. Single Versus Dual Antiplatelet Therapy After Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized Clinical Trials. Cardiovascular Revascularization Medicine 2021, 34: 46-53. PMID: 33514490, PMCID: PMC8814464, DOI: 10.1016/j.carrev.2021.01.016.Peer-Reviewed Original ResearchConceptsTranscatheter aortic valve replacementDual antiplatelet therapyAortic valve replacementLife-threatening bleedingRisk of strokeMyocardial infarctionMajor bleedingCardiac deathAntiplatelet therapyValve replacementRandomized clinical trialsSignificant differencesIschemic endpointsPrimary endpointSecondary endpointsTotal patientsClinical trialsBleedingMeta-AnalysisTrialsStrokeEndpointDeathInfarctionPatients
2020
Impella percutaneous left ventricular assist device as mechanical circulatory support for cardiogenic shock: A retrospective analysis from a tertiary academic medical center
Nouri SN, Malick W, Masoumi A, Fried JA, Topkara VK, Brener MI, Ahmad Y, Prasad M, Rabbani LE, Takeda K, Karmpaliotis D, Moses JW, Leon MB, Kirtane AJ, Garan AR. Impella percutaneous left ventricular assist device as mechanical circulatory support for cardiogenic shock: A retrospective analysis from a tertiary academic medical center. Catheterization And Cardiovascular Interventions 2020, 99: 37-47. PMID: 33325612, DOI: 10.1002/ccd.29434.Peer-Reviewed Original ResearchConceptsPercutaneous left ventricular assist deviceMechanical circulatory supportImpella percutaneous left ventricular assist deviceLeft ventricular assist deviceCardiogenic shockExtracorporeal membrane oxygenationVentricular assist deviceCirculatory supportCS patientsAssist deviceTertiary academic medical centerMultivariable logistic regression modelAcute myocardial infarctionDevice-related outcomesAcademic medical centerLogistic regression modelsHospital mortalityClinical characteristicsHemodynamic statusMembrane oxygenationClinical outcomesHemodynamic efficacyDevice implantationEntire cohortMyocardial infarctionResponse by Ahmad et al to Letter Regarding Article “Effects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials”
Ahmad Y, Howard JP, Francis DP. Response by Ahmad et al to Letter Regarding Article “Effects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials”. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006862. PMID: 32482084, DOI: 10.1161/circoutcomes.120.006862.Peer-Reviewed Original ResearchClinical Pathway for Management of Suspected or Positive Novel Coronavirus-19 Patients With ST-Segment Elevation Myocardial Infarction.
Ranard LS, Ahmad Y, Masoumi A, Chuich T, Romney MS, Gavin N, Sayan OR, Kirtane AJ, Rabbani LE. Clinical Pathway for Management of Suspected or Positive Novel Coronavirus-19 Patients With ST-Segment Elevation Myocardial Infarction. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2020, 19: 49-54. PMID: 32356955, DOI: 10.1097/hpc.0000000000000223.Peer-Reviewed Original ResearchConceptsST-elevation myocardial infarctionMyocardial infarctionNewYork-Presbyterian/Columbia University Irving Medical CenterST-segment elevation myocardial infarctionManagement of STEMIColumbia University Irving Medical CenterStandard cardiac careElevation myocardial infarctionCOVID-19 patientsCoronavirus-19 patientsCoronavirus-19 diseaseOverwhelming healthcare systemsCOVID-19 diseaseFibrinolytic therapyCardiac careMultidisciplinary panelClinical pathwayMedical CenterSTEMI mimicsHealthcare systemInfarctionPatientsDiseaseGlobal pandemicMyopericarditisComplete Revascularization by Percutaneous Coronary Intervention for Patients With ST‐Segment–Elevation Myocardial Infarction and Multivessel Coronary Artery Disease: An Updated Meta‐Analysis of Randomized Trials
Ahmad Y, Howard JP, Arnold A, Prasad M, Seligman H, Cook CM, Warisawa T, Shun‐Shun M, Ali Z, Parikh MA, Al‐Lamee R, Sen S, Francis D, Moses JW, Leon MB, Stone GW, Karmpaliotis D. Complete Revascularization by Percutaneous Coronary Intervention for Patients With ST‐Segment–Elevation Myocardial Infarction and Multivessel Coronary Artery Disease: An Updated Meta‐Analysis of Randomized Trials. Journal Of The American Heart Association 2020, 9: e015263. PMID: 32476540, PMCID: PMC7429036, DOI: 10.1161/jaha.119.015263.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionMultivessel coronary artery diseasePercutaneous coronary interventionCulprit-only revascularizationCoronary artery diseaseComplete revascularizationCoronary interventionMyocardial infarctionCardiovascular deathArtery diseaseUnplanned revascularizationMultivessel diseaseCause mortalityEnd pointPrimary efficacy end pointHard clinical outcomesEfficacy end pointSecondary end pointsClinical end pointsElevation myocardial infarctionClinical practice guidelinesTreat basisClinical outcomesRandomized trialsOptimal treatmentSafety of Revascularization Deferral of Left Main Stenosis Based on Instantaneous Wave-Free Ratio Evaluation
Warisawa T, Cook CM, Rajkumar C, Howard JP, Seligman H, Ahmad Y, El Hajj S, Doi S, Nakajima A, Nakayama M, Goto S, Vera-Urquiza R, Sato T, Kikuta Y, Kawase Y, Nishina H, Petraco R, Al-Lamee R, Nijjer S, Sen S, Nakamura S, Lerman A, Matsuo H, Francis DP, Akashi YJ, Escaned J, Davies JE. Safety of Revascularization Deferral of Left Main Stenosis Based on Instantaneous Wave-Free Ratio Evaluation. JACC Cardiovascular Interventions 2020, 13: 1655-1664. PMID: 32417088, DOI: 10.1016/j.jcin.2020.02.035.Peer-Reviewed Original ResearchMeSH KeywordsAgedClinical Decision-MakingCoronary Artery BypassCoronary Artery DiseaseCoronary StenosisEuropeFemaleFractional Flow Reserve, MyocardialHumansJapanMaleMiddle AgedPercutaneous Coronary InterventionPredictive Value of TestsProspective StudiesRegistriesRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsInstantaneous wave-free ratioNonfatal myocardial infarctionPrimary endpointLM stenosisCause deathLesion revascularizationSecondary endpointsCardiac deathMyocardial infarctionIschemia-driven target lesion revascularizationSimilar long-term outcomesStable coronary artery diseaseMain coronary artery stenosisLong-term clinical outcomesSafety of deferralMulticenter observational studyTarget lesion revascularizationLeft main stenosisCoronary artery diseaseLong-term outcomesCoronary artery stenosisDeferred groupLM revascularizationMedian followRevascularization deferralResponse by Ahmad et al to Letter Regarding Article, “Effects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials”
Ahmad Y, Howard JP, Francis DP. Response by Ahmad et al to Letter Regarding Article, “Effects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials”. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006642. PMID: 32283970, DOI: 10.1161/circoutcomes.120.006642.Peer-Reviewed Original ResearchMortality after drug-eluting stents vs. coronary artery bypass grafting for left main coronary artery disease: a meta-analysis of randomized controlled trials
Ahmad Y, Howard JP, Arnold AD, Cook CM, Prasad M, Ali ZA, Parikh MA, Kosmidou I, Francis DP, Moses JW, Leon MB, Kirtane AJ, Stone GW, Karmpaliotis D. Mortality after drug-eluting stents vs. coronary artery bypass grafting for left main coronary artery disease: a meta-analysis of randomized controlled trials. European Heart Journal 2020, 41: 3228-3235. PMID: 32118272, PMCID: PMC7557472, DOI: 10.1093/eurheartj/ehaa135.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graft surgeryPercutaneous coronary interventionDrug-eluting stentsMain coronary artery diseaseCoronary artery diseaseMyocardial infarctionCardiac deathUnplanned revascularizationCause mortalityCoronary interventionArtery diseaseLeft main coronary artery diseaseRandomized clinical trial evidenceSimilar long-term mortalityArtery bypass graft surgerySignificant differencesUnplanned revascularization proceduresWeighted mean followBypass graft surgeryCoronary artery bypassPrimary efficacy endpointClinical trial evidenceLong-term mortalityRisk of strokeGold standard therapyEffects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease
Chacko L, Howard J, Rajkumar C, Nowbar AN, Kane C, Mahdi D, Foley M, Shun-Shin M, Cole G, Sen S, Al-Lamee R, Francis DP, Ahmad Y. Effects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006363-e006363. PMID: 32063040, PMCID: PMC7034389, DOI: 10.1161/circoutcomes.119.006363.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAdultAgedAged, 80 and overCause of DeathClinical Decision-MakingCoronary Artery DiseaseFemaleHumansMaleMiddle AgedNon-ST Elevated Myocardial InfarctionPercutaneous Coronary InterventionRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeYoung AdultConceptsST-segment elevation myocardial infarctionStable coronary artery diseaseUnstable coronary artery diseasePercutaneous coronary interventionCoronary artery diseaseSegment elevation acute coronary syndromesAcute coronary syndromeMyocardial infarctionCardiac deathMultivessel diseaseCoronary syndromeCoronary interventionArtery diseaseBenefits of PCITrials of PCITreatment of CADCulprit-only revascularization strategyEarly percutaneous coronary interventionPrimary percutaneous coronary interventionPatients post-myocardial infarctionResidual coronary lesionsPrimary end pointComparative Health EffectivenessPost-myocardial infarctionImmediate revascularization
2019
Clinical Events After Deferral of LAD Revascularization Following Physiological Coronary Assessment
Sen S, Ahmad Y, Dehbi HM, Howard JP, Iglesias JF, Al-Lamee R, Petraco R, Nijjer S, Bhindi R, Lehman S, Walters D, Sapontis J, Janssens L, Vrints CJ, Khashaba A, Laine M, Van Belle E, Krackhardt F, Bojara W, Going O, Härle T, Indolfi C, Niccoli G, Ribichini F, Tanaka N, Yokoi H, Takashima H, Kikuta Y, Erglis A, Vinhas H, Silva PC, Baptista SB, Alghamdi A, Hellig F, Koo BK, Nam CW, Shin ES, Doh JH, Brugaletta S, Alegria-Barrero E, Meuwissen M, Piek JJ, van Royen N, Sezer M, Di Mario C, Gerber RT, Malik IS, Sharp ASP, Talwar S, Tang K, Samady H, Altman J, Seto AH, Singh J, Jeremias A, Matsuo H, Kharbanda RK, Patel MR, Serruys P, Escaned J, Davies JE. Clinical Events After Deferral of LAD Revascularization Following Physiological Coronary Assessment. Journal Of The American College Of Cardiology 2019, 73: 444-453. PMID: 30704577, PMCID: PMC6354033, DOI: 10.1016/j.jacc.2018.10.070.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsInstantaneous wave-free ratioFractional flow reserveLAD lesionsMyocardial infarctionUnplanned revascularizationLeft anterior descending (LAD) arteryEvent ratesLower myocardial infarctionAdverse cardiac eventsAnterior descending (LAD) arteryPhysiological assessmentLow event ratesMACE rateCardiac eventsCardiovascular deathClinical eventsFlow reserveHigh riskPatientsLesionsLADRevascularizationTrialsTreatment