8. Revascularisation strategy in ACS

Complete vs infarct artery-only revascularisation in STEMI patients with multivessel disease

DANAMI-3-PRIMULTI 10 years
Objective
to determine whether FFR-guided complete revascularisation reduces 10-year clinical events (including repeated events) compared with infarct-related artery-only PCI in STEMI with multivessel disease
Study
open-label, randomised controlled trial
Population
STEMI patients with multivessel coronary disease and 1 angiographically significant non infarct-related lesion, randomised to infarct artery-only PCI or FFR-guided complete revascularisation
Endpoints
composite of all-cause mortality, recurrent myocardial infarction, or any revascularisation, including analysis of repeated MI and revascularisation events over 10 years
DANAMI-3-PRIMULTI 10 years
DANAMI-3-PRIMULTI 10 years
Conclusion
When compared to infarct-related artery PCI, FFR-guided complete revascularisation was found to reduce future and repeated events after 10 years, with risk primarily driven by revascularisation.
Marquard et al. J Am Coll Cardiol. 2025 Jul 15.
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