DECisive Intracoronary PHysiology and Imaging in the Evaluation and Reclassification of Non-culprit Lesions in Acute Coronary Syndrome

Exclusion Criteria

• •Advanced renal insufficiency to the extent that the patient cannot tolerate the additional contrast load required for intracoronary imaging (IC-OCT) (e.g., eGFR \< 30 mL/min/1.73 m²).
• •Known serious allergy or absolute contraindication to the hyperemic agents to be used (e.g., adenosine, papaverine), iodinated contrast agents, or mandatory antiplatelet/anticoagulant therapy.
• •Patients presenting to the hospital due to heart failure and cardiogenic shock.
• •Additional investigation required due to in-stent restenosis of a non-culprit vessel.
• •Patients with blood disorders, bleeding disorders, cancer, end-stage liver or kidney failure, patients with active bleeding, and pregnant women.
• •Presence of significant stenosis in the left main coronary artery (LMCA) or the patient having previously undergone coronary artery bypass graft (CABG) surgery.
• •Failure of PCI on the culprit lesion in the index procedure, no-reflow, etc. The vessel containing the non-culprit lesion has technical impediments that prevent safe passage of the IC-OCT catheter or pressure/flow wire (e.g., excessive tortuosity, advanced angulation, very dense calcification, or chronic total occlusion \[CTO\]).