Occlusion-Focused Triage vs Very-High-Risk NSTEMI Criteria: A DIFOCCULT-3 Substudy
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: A DIFOCCULT-3 Substudy. JACC Cardiovasc Interv. Published 12 October 2026. doi:10.
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