Complete Revascularization Guided by Functional Coronary Angiography in STEMI.

Functional coronary angiography-guided revascularization reduces primary-outcome events by 38% compared to conventional angiography in STEMI patients with multivessel disease.

• Why it matters: Effective identification of nonculprit lesions for revascularization remains uncertain, impacting patient outcomes and treatment strategies in STEMI with multivessel disease.
• What they did: The trial randomized 1823 patients to either physiology-guided or angiography-guided complete revascularization, assessing outcomes over a median of 17.9 months using composite clinical endpoints.
• The result: The physiology-guided approach significantly lowered the risk of death, myocardial infarction, stroke, or revascularization, and also reduced safety events, supporting its use for better patient prognosis.