Complete Revascularization Guided by Functional Coronary Angiography in STEMI.
N Engl J MedAug 29, 2026 (epub)
Clinical ResearchCardiology
Simone Biscaglia, Andrea Erriquez, Iginio Colaiori et al.
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In 30 seconds
This randomized controlled trial evaluated the effectiveness of complete coronary-artery revascularization guided by functional coronary angiography versus conventional angiography in patients with STEMI and multivessel disease. Among 1823 patients, the physiology-guided approach resulted in a lower incidence of primary outcome events (8.9% vs 13.7%) at a median follow-up of 17.9 months, with a hazard ratio of 0.62.
Key findings
- The physiology-guided group had 8.9% primary outcome events compared to 13.7% in the angiography-guided group.
- The hazard ratio for primary outcome events was 0.62, indicating a significant reduction in risk.
- Primary safety outcomes occurred in 4.6% of the physiology-guided group versus 7.1% in the angiography-guided group.
- The hazard ratio for primary safety outcomes was 0.63, suggesting improved safety with the physiology-guided approach.
Why it matters
This study highlights the potential benefits of using functional coronary angiography for complete revascularization in STEMI patients, which may lead to better clinical outcomes and reduced complications.