Optimal timing of staged complete revascularization in STEMI with multivessel 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 prospective, multicenter trial enrolls STEMI patients with multivessel disease who have had successful PCI of the infarct-related artery. After eligibility, participants are randomized 1:1 to either in-hospital staged revascularization on a separate day (at least 48 hours after IRA PCI) or out-of-hospital staged revascularization within 15 to 45 days after randomization. Non-IRA lesions with 50-69% stenosis are evaluated with fractional flow reserve to guide PCI decisions. The trial aims to determine the optimal timing of staged complete revascularization guided by FFR in terms of safety and effectiveness compared with current practice. The study builds on prior evidence showing complete revascularization is beneficial and seeks to clarify timing in a real-world, multicenter setting.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age ≥19 years
* ST-segment elevation myocardial infarction (STEMI): ST-segment elevation ≥ 0.1 mV in at least two contiguous leads, or New-onset left bundle branch block (LBBB)
* Primary PCI within 12 h after symptom development
* At least 1 non-infarct related artery (non-IRA) with diameter ≥ 2.5 mm and 50% stenosis by visual estimation

Exclusion Criteria:

* Cardiogenic shock at initial presentation or after infarct-related artery (IRA) treatment
* Thrombolysis in myocardial infarction flow at non-IRA ≤ 2
* Severe procedural complications during primary percutaneous coronary intervention that, in the judgement of the operator, preclude study enrollment
* Non-IRA lesion unsuitable for percutaneous coronary intervention (PCI) treatment that, in the judgement of the operator, preclude study enrollment
* Chronic total occlusion in a non-IRA
* History of anaphylaxis to contrast agent
* Pregnancy and lactation
* Life expectancy \< 1 year
* Severe valvular heart disease
* History of coronary artery bypass grafting (CABG) or planned CABG
* Fibrinolysis therapy prior to admission
* Severe asthma

Where it's running

• Chonnam National University Hospital
  Gwangju, South Korea Recruiting
• Bucheon Sejong Hospital
  Bucheon-si, South Korea Not yet recruiting
• Gyeongsang National University Changwon Hospital
  Changwon, South Korea Not yet recruiting
• Samsung Changwon Medical Center
  Changwon, South Korea Not yet recruiting
• Soon Chun Hyang University Hospital Cheonan
  Cheonan, South Korea Not yet recruiting
• Chungbuk National University Hospital
  Cheongju-si, South Korea Not yet recruiting

Study contacts

• Principal investigator: Youngkeun Ahn, MD, PhD — Chonnam National University Hospital
• Study coordinator: Min Chul Kim, MD, PhD
• Email: kmc3242@hanmail.net
• Phone: 82-10-4606-2643

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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.