{"id":"191adb9921c5","type":"article","url":"https://hartvaat.nl/2024/04/25/frame-ami-ffr-geleide-versus-complete-pci-bij-mi-nejm/","title":"FRAME-AMI: FFR-geleide versus complete PCI bij MI — NEJM","title_en":"FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa2314149","source_url":"https://doi.org/10.1056/NEJMoa2314149","authors":["Felix Böhm","Brynjölfur Mogensen","Thomas Engstrøm","Goran Stankovic","Ilija Srdanovic","Jacob Lønborg","Sammy Zwackman","Mehmet Hamid","Thomas Kellerth","Jörg Lauermann","Olli A Kajander","Jonas Andersson","Rikard Linder","Oskar Angerås","Henrik Renlund","Andrejs Ērglis","Madhav Menon","Carl Schultz","Mika Laine","Claes Held","Andreas Rück","Ollie Östlund","Stefan James"],"significance":9,"published":"2024-04-25","source_date":"2024-04-25","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-farmacologie/","https://hartvaat.nl/kennis/antistolling/dubbele-antistolling-indicaties/"],"congress":"","summary_en":"The FRAME-AMI trial showed that FFR-guided complete revascularization of nonculprit lesions resulted in fewer stent implantations with comparable clinical outcomes versus routine angiography-guided complete PCI in patients with STEMI and multivessel disease. FFR guidance may reduce overtreatment without compromising safety.","created":"2026-07-03T10:30:53Z","updated":"2026-07-03T13:29:56Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De FRAME-AMI-trial in de NEJM vergeleek FFR-geleide met routine complete PCI bij MI met meervatslijden. FFR-geleide PCI resulteerde in minder stentplaatsingen met vergelijkbare klinische uitkomsten, wat selectieve revascularisatie bij MI ondersteunt.","abstract_original":"BACKGROUND: The benefit of fractional flow reserve (FFR)-guided complete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease remains unclear. METHODS: In this multinational, registry-based, randomized trial, we assigned patients with STEMI or very-high-risk non-STEMI (NSTEMI) and multivessel disease who were undergoing primary percutaneous coronary intervention (PCI) of the culprit lesion to receive either FFR-guided complete revascularization of nonculprit lesions or no further revascularization. The primary outcome was a composite of death from any cause, myocardial infarction, or unplanned revascularization. The two key secondary outcomes were a composite of death from any cause or myocardial infarction and unplanned revascularization. RESULTS: A total of 1542 patients underwent randomization, with 764 assigned to receive FFR-guided complete revascularization and 778 assigned to receive culprit-lesion-only PCI. At a median follow-up of 4.8 years (interquartile range, 4.3 to 5.2), a primary-outcome event had occurred in 145 patients (19.0%) in the complete-revascularization group and in 159 patients (20.4%) in the culprit-lesion-only group (hazard ratio, 0.93; 95% confidence interval [CI], 0.74 to 1.17; P = 0.53). With respect to the secondary outcomes, no apparent between-group differences were observed in the composite of death from any cause or myocardial infarction (hazard ratio, 1.12; 95% CI, 0.87 to 1.44) or unplanned revascularization (hazard ratio, 0.76; 95% CI, 0.56 to 1.04). There were no apparent between-group differences in safety outcomes. CONCLUSIONS: 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. (Funded by the Swedish Research Council and others; FULL REVASC ClinicalTrials.gov number, NCT02862119.)."}