2015Acute coronary syndromesIntervention627 patients

DANAMI-3—PRIMULTI

Therapy group: Complete revascularisation · Therapy: FFR-guided complete revascularisation in STEMI

In STEMI with multivessel disease, FFR-guided complete revascularisation reduced clinical events compared with culprit-only treatment.

Published in Lancet (2015)

Question: In patients with ST-elevation myocardial infarction and multivessel disease, does FFR-guided complete revascularisation improve clinical outcomes compared with treating only the infarct-related artery?
Design: Open-label, randomised (1:1) trial at two university hospitals in Denmark, enrolling 627 patients between March 2011 and February 2014. Intention-to-treat analysis with a median follow-up of 27 months (range 12–44 months).
Population: Patients with STEMI who had one or more clinically significant coronary stenoses in addition to the infarct-related lesion, after successful primary PCI of the infarct-related artery.
Intervention: FFR-guided complete revascularisation before discharge (314 patients): non-culprit lesions with angiographic stenosis >50% and FFR <0.80 were treated, and stenoses >90% without prior FFR, in a separate procedure during the index admission.
Control: No further invasive treatment after PCI of the infarct-related artery (313 patients); both groups received best medical treatment.
Primary outcome: Composite of all-cause mortality, non-fatal reinfarction, and ischaemia-driven revascularisation of lesions in non-infarct-related arteries.
Conclusion: FFR-guided complete revascularisation reduced the risk of future events compared with no further intervention after primary PCI, driven by fewer repeat revascularisations.
Why it matters: It supported treating significant non-culprit lesions during the STEMI admission to avoid repeat revascularisation, while leaving open the question of optimal timing and the effect on hard endpoints.

Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.

Some figures could not be verified automatically and were left out of this card.

Generated on October 14, 2026

Sources

Original publication on PubMed (PMID 26347918) ↗Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3—PRIMULTI): an open-label, randomised controlled trial.
Journal article (DOI) ↗
ClinicalTrials.gov record (NCT01960933) ↗

Videos explaining it

10 Year Outcome of DANAMI 3 PRIMULTI | JACC | EuroPCR.25

ACC · American College of Cardiology ↗16:13Video page

Source: American College of Cardiology · YouTube
Date: 20 May 2025
Audio: English
Subtitles: MultilingualYouTube
Audio transl.: Unconfirmed · check ⚙YouTube

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Podcasts explaining it

10 Year Outcome of DANAMI 3 PRIMULTI | JACC | EuroPCR.25 | JACC
ACC · JACC This Week ↗16 minEpisode page
Source
ACC · Apple Podcasts
Date
19 May 2025
Audio
English
Translation
TextGoogle Chrome
Audio transl.
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