The following is a summary of “FFR-Guidance for complete nonculprit revascularization – FULL REVASC,” published in the April 2024 issue of Cardiology by Bavry et al.
Researchers conducted a prospective study evaluating the efficacy of physiology-guided complete revascularization compared with usual care in patients with STEMI and multivessel coronary disease after culprit-vessel PCI.
They randomized patients with STEMI who underwent culprit-vessel PCI to either physiology-guided revascularization of non-culprit lesions (n = 764) or usual care (n = 778). The mean age of patients was 65 years, 21% female, and 16% patients with diabetes in the trial. Fractional flow reserve (FFR) was used to assess coronary physiology. Inclusion criteria included STEMI and culprit-vessel PCI with ≥1 non-culprit lesion, while exclusion criteria comprised previous coronary artery bypass grafting, left central disease, and cardiogenic shock.
The results showed that the primary outcome incidence at a median of 4.8 years was 19.0% in the complete revascularization group, less than that of usual care, 20.4% (P=0.53). Secondary outcomes showed no significant differences in death or MI occurring in the revascularization group or usual care group, 16.5% vs 15.3%, respectively(P=NS[Not significant]), and unplanned revascularization, 9.2% vs 11.7% (P=NS).
Investigators concluded that Physiology-guided complete revascularization didn’t improve outcomes for patients with STEMI undergoing culprit-vessel PCI.
Source: acc.org/Latest-in-Cardiology/Clinical-Trials/2024/04/05/14/15/full-revasc
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