Should Patients with NSTEMI Undergo Early Nonculprit-Vessel Revascularization?

Whether fractional-flow reserve (FFR)-guided percutaneous coronary intervention (PCI) improves outcomes in patients presenting with non–ST-segment elevation myocardial infarction (NSTEMI) with multivessel coronary artery disease (CAD) is unknown. The SLIM trial randomized patients with NSTEMI 1:1 to FFR-guided or culprit-only PCI. The primary composite outcome was all-cause death, nonfatal myocardial infarction (MI), any revascularization, and stroke. Interventionists measured FFR during the index procedure and performed PCI for all hemodynamically significant disease within 72 hours.