Primary PCI is done: what about the rest? COMPARE ACUTE
The session - entirely devoted to interventional cardiology – started with COMPARE ACUTE, a trial of FFR-guided complete revascularization beyond the culprit lesion in patients with STEMI.
Reported from the American College of Cardiology 2017 Scientific Sessions in Washington.
Compared with conventional conservative treatment (a strategy already challenged by previous trials like PRAMI, CVLPRIT and DANAMI-3), patients who had FFR-guided revascularization of the non-culprit lesion(s) experienced significantly less combined death from any cause, nonfatal myocardial infarction, revascularization, or cerebrovascular events at 12 months.
This benefit was driven essentially by significantly less revascularization, but myocardial infarction also pointed to the right direction. This trial being open-label, skeptics will argue that differences in revascularization are biased by the knowledge of the underlying angiographic condition, which may prompt the use of more aggressive strategies in patients belonging to the conservative arm.