Objective
to compare immediate percutaneous coronary intervention (PCI) guided by instantaneous wave free ratio (iFR) and deferred PCI guided by cardiac stress magnetic resonance imaging (MRI) in patients with STEMI and multivessel disease
Study
investigator-initiated, open-label, randomised controlled trial
Population
STEMI patients with multivessel disease (at least one nonculprit lesion >50% stenosis suitable for PCI) who were successfully reperfused with TIMI 3 flow within 12 hours of symptom onset
Endpoints
3-year composite of all-cause death, recurrent MI, or heart failure hospitalisation
Conclusion
In STEMI patients who underwent successful primary PCI, immediate iFR-guided PCI was not found to be superior to deferred cardiac stress MRIguided PCI of nonculprit coronary artery lesions in terms of death from any cause, recurrent myocardial infarction, or hospitalisation for heart failure at three years.
Nijveldt et al. N Engl J Med. 2025 Oct 28.