- Question
- Does FFR-guided complete revascularization of nonculprit lesions improve clinical outcomes compared with culprit-only PCI in patients with myocardial infarction and multivessel disease?
- Design
- Multinational, registry-based, open-label randomized trial with 1542 patients randomized. Median follow-up was 4.8 years.
- Population
- Patients with STEMI or very-high-risk NSTEMI and multivessel coronary artery disease undergoing primary PCI of the culprit lesion.
- Intervention
- FFR-guided complete revascularization of nonculprit lesions (764 patients) in addition to culprit-lesion PCI. Per the registry, treatment was indicated for an FFR value ≤0.80.
- Control
- Culprit-lesion-only PCI with no further revascularization (778 patients), with medical therapy at the investigators' discretion.
- Primary outcome
- Composite of death from any cause, myocardial infarction, or unplanned revascularization.
- Results
- A primary-outcome event occurred in 145 patients (19.0%) with complete revascularization and 159 (20.4%) with culprit-only PCI (HR 0.93; 95% CI 0.74 to 1.17; P = 0.53). No apparent differences were seen in death or myocardial infarction (HR 1.12; 95% CI 0.87 to 1.44) or unplanned revascularization (HR 0.76; 95% CI 0.56 to 1.04).
- Safety
- No apparent between-group differences were observed in safety outcomes.
- Conclusion
- FFR-guided complete revascularization was not shown to lower the composite of death, myocardial infarction, or unplanned revascularization compared with culprit-only PCI at 4.8 years.
- Why it matters
- It added evidence that in myocardial infarction with multivessel disease an FFR-guided strategy showed no clear benefit over treating the culprit alone, tempering routine complete revascularization.
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.
Generated on October 18, 2026