Coronary disease & ACSRandomised controlled trial
Complete Revascularization Guided by Functional Coronary Angiography in STEMI
- Randomised controlled trial
- international
Authors' conclusion
In patients with STEMI and multivessel coronary artery disease, a strategy of complete coronary-artery revascularization guided by functional coronary angiography resulted in a lower risk of a primary-outcome event (death, myocardial infarction, cerebrovascular accident, or ischemia-driven revascularization) than a strategy guided by conventional angiography.
Study context
- Population
- Patients with STEMI and multivessel disease after successful culprit-lesion treatment
- Participants
- 1,823 patients
- Comparison
- Physiology-guided vs angiography-guided complete revascularization
- Physiology-guidedn = 913
- Angiography-guidedn = 910reference
- Primary endpoint
- Composite of:
- All-cause death
- MI
- Cerebrovascular accident (stroke or TIA)
- Ischemia-driven revascularization (time-to-event)
- Follow-up
- Median 17.9 months
Primary result
As reported in the abstract
Hazard ratio
0.62
95% CI 0.47–0.83
P < 0.001
Events by treatment group
Physiology-guided vs Angiography-guided
HR 0.62 (95% CI 0.47–0.83); P < 0.001
Safety
| Outcome | Physiology-guided | Angiography-guided | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Primary safety outcome: contrast-associated AKI or major bleeding | 4.6% | 7.1% | 0.63 (0.43–0.93) | P = 0.02 | |
| 0.512Hazard ratio (log scale) |
Original publication
Complete Revascularization Guided by Functional Coronary Angiography in STEMI. N Engl J Med. Published 29 August 2026. doi:10.1056/nejmoa2605373
Summarised from the published abstract; every number is checked against it