Should Patients with NSTEMI Undergo Early Nonculprit-Vessel Revascularization?

Clinical Takeaway

: Yes, according to a recent randomized controlled trial.

Context

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.

Key Results

Among 478 participants followed for 1 year, the primary outcome occurred in a significantly smaller proportion of participants in the FFR-gui…

Reviewing Author

Shea Hogan, MD, MSCS, FSVM, FACC, FSCAI

Disclosures

Editorial BoardsVascular Medicine