10-year outcome of fractional flow reserve-guided complete revascularization in patients with ST-segment elevation myocardial infarction - A DANAMI-3 PRIMULTI substudy.
Utsho Islam, Jasmine Melissa Marquard, Ibrahim Mohammed Abdul Khalek et al.
✦ AI-curated · Sources linked
In 30 seconds
This randomized controlled trial evaluated the long-term outcomes of patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, comparing those who underwent PCI of non-culprit lesions to those who had PCI deferred based on fractional flow reserve (FFR) values >0.80. Over a median follow-up of 10.5 years, the composite outcome occurred in 36% of the PCI group versus 47% in the PCI-deferral group (adjusted HR 0.64).
Key findings
- The composite outcome occurred in 36% of the PCI group compared to 47% in the PCI-deferral group.
- Adjusted HR for the composite outcome was 0.64 (95% CI: 0.44-0.95, p=0.025).
- PCI-deferral was linked to a higher risk of cardiovascular mortality (adjusted HR 0.48, CI 95% 0.24-0.97, p=0.040).
Why it matters
The findings suggest that deferring PCI in patients with STEMI and multivessel disease based on FFR may lead to worse long-term outcomes, including increased mortality and urgent revascularization, highlighting the importance of evaluating non-culprit lesions.