FULL REVASC Trial: FFR-Guided Complete PCI in MI

full revasc trial

Year: 2024 Title: FULL REVASC Subtitle: FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction Type of Trial: A registry-based, randomized, parallel, blinded trial

Objective: To evaluate the benefit of fractional flow reserve (FFR)–guided complete revascularization compared with usual care (i.e., culprit-lesion-only PCI) among patients with STEMI and multivessel coronary disease who underwent culprit-vessel percutaneous coronary intervention (PCI).

Patients: 1542

Inclusion Criteria:

  • 18 Years and older
  • STEMI and culprit-vessel PCI
  • ≥1 non-culprit lesion

Exclusion Criteria:

  • Previous coronary artery bypass grafting
  • Left main disease
  • Cardiogenic shock


  • FFR-Guided Complete Revascularization (n = 764)
  • Culprit-Lesion-Only PCI (n = 778)

Primary Outcome:

  • A composite of death from any cause, MI, or unplanned revascularization at a median of 4.8 years %
  • HR, 0.93; 95% CI, 0.74 to 1.17 (P=0.53)
  • FFR-Guided Complete Revascularization Group: 19.0%
  • Culprit-Lesion-Only PCI Group: 20.4%

Secondary Outcomes:

  1. The composite of death from any cause or MI %
    • FFR-Guided Group: 16.5%
    • Culprit-Lesion-Only PCI Group: 15.3%
  2. Unplanned revascularization %
    • FFR-Guided Group: 9.2%
    • Culprit-Lesion-Only PCI Group: 11.7%

Conclusion: Among patients with STEMI or very-high-risk NSTEMI and multivessel coronary artery disease, FFR-guided complete revascularization was not shown to result in a lower risk of a composite of death from any cause, myocardial infarction, or unplanned revascularization than culprit-lesion-only PCI at 4.8 years.

Reference: Böhm F et al. N Engl J Med 2024; DOI: 10.1056/NEJMoa2401479

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