Coronary disease & ACSRandomised controlled trial
Fractional Flow Reserve–Guided Complete vs Culprit-Only Revascularization in Non–ST-Elevation Myocardial Infarction and Multivessel Disease
- Randomised controlled trial
- prospective
- investigator-initiated
- multicentre
- international
- 9 hospitals in Europe
Enrolled June 2018 to July 2024; final follow-up July 21, 2025
Authors' conclusion
FFR-guided complete revascularization during the index procedure resulted in a significant reduction in the composite of all-cause death, nonfatal myocardial infarction, any revascularization, and stroke at 1 year. This was mainly driven by reduced repeat revascularization.
Study context
- Population
- Patients with NSTEMI and multivessel disease after successful culprit-lesion revascularization, ≥1 nonculprit stenosis ≥50%7 crossovers in culprit-only
- Participants
- 478 patients
- Comparison
- Fractional flow reserve (FFR)-guided complete vs culprit-only revascularization
- FFR-guided complete revascularizationn = 240
- Culprit-onlyn = 238reference
- Primary endpoint
- Composite of:
- All-cause death
- Nonfatal MI
- Any revascularization
- Stroke
- Follow-up
- 1 year
Primary result
As reported in the abstract
Hazard ratio
0.38
95% CI 0.20–0.72
P = 0.003
Events by treatment group
FFR-guided complete revascularization vs Culprit-only
HR 0.38 (95% CI 0.20–0.72); P = 0.003
Secondary outcomes
Remaining secondary outcomes (other primary components, all-cause death or nonfatal MI, cardiac rehospitalization, bleeding)
- No significant differences
Original publication
Fractional Flow Reserve–Guided Complete vs Culprit-Only Revascularization in Non–ST-Elevation Myocardial Infarction and Multivessel Disease. JAMA. Published 11 November 2025. doi:10.1001/jama.2025.16189
Summarised from the published abstract; every number is checked against it