Evaluating revascularization strategies for patients with NSTEMI and multivessel coronary artery disease

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial aims to assess the efficacy and safety of two different revascularization strategies in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel coronary artery disease (MVD). Participants will be randomly assigned to receive either immediate complete revascularization during the initial procedure or a staged approach where non-infarct-related arteries are treated later. The study will utilize fractional flow reserve (FFR) to guide interventions for certain lesions. The goal is to determine which strategy leads to better clinical outcomes for patients with this condition.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age ≥ 19 years old
2. Non-ST-segment elevation myocardial infarction

   * Angina pectoris or equivalent ischemic chest discomfort with at least 1 of 3 features and,

     * occurs at rest, usually lasting \> 10 minutes
     * severe and new onset (within the prior 4-6 weeks)
     * crescendo pattern
   * Elevated cardiac biomarkers and,

     * ≥ 99% value of high-sensitivity cardiac troponin
   * No ST-segment elevation ≥ 0.1 mV in ≥ 2 contiguous leads or newly developed left bundle branch block on 12-lead electrocardiogram
3. PCI within 72 hours after symptom development
4. Multivessel disease: Non-IRA with at least 2.5 mm diameter and 50% diameter stenosis by visual estimation
5. Patient's or protector's agreement about study design and the risk of PCI

Exclusion Criteria:

1. Cardiogenic shock at initial presentation or after treatment of IRA
2. TIMI flow at non-IRA ≤ 2
3. Severe procedural complications (e.g. persistent no-reflow phenomenon, coronary artery perforation) which restricts study enrollment by operators' decision
4. Non-IRA lesion not suitable for PCI treatment by operators' decision
5. Chronic total occlusion at non-IRA
6. History of anaphylaxis to contrast agent
7. Pregnancy and lactation
8. Life expectancy \< 1-year
9. Severe valvular disease
10. History of CABG, or planned CABG
11. Fibrinolysis before admission

Where it's running

• Chonnam National University Hospital
  Gwangju, South Korea Recruiting

Study contacts

• Principal investigator: Min Chul Kim, MD — Chonnam National University Hospital
• Study coordinator: Min Chul Kim, MD
• Email: kmc3242@hanmail.net
• Phone: 82-62-220-6578

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.