Occlusion-Focused Triage vs Very-High-Risk NSTEMI Criteria
- substudy of the multicenter, cluster-randomized DIFOCCULT-3 (Time for a Diagnostic Paradigm Shift From ST-Elevation/Non-ST-Elevation to Occlusion/Non-Occlusion Myocardial Infarction-3) trial
Authors' conclusion
An occlusion-focused diagnostic approach was associated with substantially higher rates of immediate invasive management and earlier identification of patients with adjudicated ACO.
Study context
- Population
- Consecutive adult patients without diagnostic STE on the admission electrocardiogram
- Participants
- 4,398 patients
- Comparison
- compare the occlusive and nonocclusive myocardial infarction (OMI/NOMI) classification with guideline-defined very-high-risk non-ST-segment elevation myocardial infarction (NSTEMI) criteria for the identification of acute coronary occlusion (ACO) in patients without diagnostic STE
Primary result
As reported in the abstract
Very-high-risk NSTEMI criteria
- very-high-risk NSTEMI criteria identified a small proportion of patients and were inconsistently translated into early intervention
Further findings
Early invasive management · within 2 hours
P < 0.001
Adjudicated ACO identified within 2 hours
P < 0.001
Adjudicated ACO identified within 2 hours
- without reduction in angiographic yield
Original publication
Occlusion-Focused Triage vs Very-High-Risk NSTEMI Criteria. JACC Cardiovasc Interv. Published 12 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it