Coronary disease & ACSRandomised controlled trial
Physiology-Guided Complete Revascularization in Older Patients With Myocardial Infarction
- Randomised controlled trial
- investigator-initiated
- multicentre (34 centres, 3 countries)
- prospective
- superiority
Authors' conclusion
In patients 75 years or older with MI and multivessel disease, the benefit of physiology-guided complete revascularization over culprit-lesion-only treatment was sustained at 3 years.
Study context
- Population
- Patients aged ≥75 years with myocardial infarction (MI) (STEMI or NSTEMI) and multivessel disease, hospitalized after successful culprit-lesion treatmentmedian age 80
- Participants
- 1,445 patients
- Comparison
- Physiology-guided complete revascularization vs culprit-only treatment
- Primary endpoint
- Composite of:
- Death
- MI
- Stroke
- Ischemia-driven revascularization
- Follow-up
- 3 years
Primary result
As reported in the abstract
Hazard ratio
0.72
95% CI 0.58–0.88
P = 0.002
Events by treatment group
Physiology-guided complete revascularization vs Culprit-only
HR 0.72 (95% CI 0.58–0.88); P = 0.002
Secondary outcomes
| Outcome | Physiology-guided complete revascularization | Culprit-only | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| CV death or MI (key secondary) | 12.8% | 18.2% | 0.66 (0.50–0.88) | P = 0.004 | |
| HF hospitalization | 14.3% | 19.7% | 0.73 (0.54–0.97) | P = 0.03 | |
| 0.512Hazard ratio (log scale) |
Original publication
Physiology-Guided Complete Revascularization in Older Patients With Myocardial Infarction. JAMA Cardiol. Published 1 November 2025. doi:10.1001/jamacardio.2025.3099
Summarised from the published abstract; every number is checked against it