Coronary disease & ACSRandomised controlled trial
FFR-Guided Complete or Culprit-Only Percutaneous Coronary Intervention (PCI) in Patients with Myocardial Infarction
- Randomised controlled trial
- multinational
- registry-based
Authors' conclusion
Among patients with STEMI or very-high-risk NSTEMI and multivessel coronary artery disease, FFR-guided complete revascularization was not shown to result in a lower risk of a composite of death from any cause, myocardial infarction, or unplanned revascularization than culprit-lesion-only PCI at 4.8 years.
Study context
- Population
- Patients with STEMI or very-high-risk non-STEMI (NSTEMI) and multivessel disease undergoing primary PCI of the culprit lesion
- Participants
- 1,542 patients
- Comparison
- Fractional flow reserve (FFR)-guided complete revascularization vs culprit-lesion-only PCI
- Complete revascularizationn = 764
- Culprit-lesion-onlyn = 778reference
- Primary endpoint
- Composite of:
- Death from any cause
- MI
- Unplanned revascularization
- Follow-up
- Median 4.8 years
Primary result
As reported in the abstract
median 4.8 years (IQR 4.3 to 5.2)
Hazard ratio
0.93
95% CI 0.74–1.17
P = 0.53
Events by treatment group
Complete revascularization vs Culprit-lesion-only
HR 0.93 (95% CI 0.74–1.17); P = 0.53
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| Death from any cause or MI (key secondary) | 1.12 (0.87–1.44) | |
| Unplanned revascularization (key secondary) | 0.76 (0.56–1.04) | |
| 0.512Hazard ratio (log scale) |
Safety
Safety outcomes
- No apparent between-group differences in safety outcomes
Original publication
FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction. N Engl J Med. Published 8 April 2024. doi:10.1056/nejmoa2314149
Summarised from the published abstract; every number is checked against it