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Instantaneous wave-free ratio guided multivessel revascularisation during percutaneous coronary intervention for acute myocardial infarction: study protocol of the randomised controlled iMODERN trial.


ABSTRACT:

Introduction

Recent randomised clinical trials showed benefit of non-culprit lesion revascularisation in ST-elevation myocardial infarction (STEMI) patients. However, it remains unclear whether revascularisation should be performed at the index procedure or at a later stage.

Methods and analysis

The instantaneous wave-free ratio (iFR) Guided Multivessel Revascularisation During Percutaneous Coronary Intervention for Acute Myocardial Infarction trial is a multicentre, randomised controlled prospective open-label trial with blinded evaluation of endpoints. After successful primary percutaneous coronary intervention (PCI), eligible STEMI patients with residual non-culprit lesions are randomised, to instantaneous wave-free ratio guided treatment of non-culprit lesions during the index procedure versus deferred cardiac MR-guided management within 4 days to 6 weeks. The primary endpoint of the study is the combined occurrence of all-cause death, recurrent myocardial infarction and hospitalisation for heart failure at 12 months follow-up. Clinical follow-up includes questionnaires at 3 months and outpatient visits at 6 months and 12 months after primary PCI. Furthermore, a cost-effectiveness analysis will be performed.

Ethics and dissemination

Permission to conduct this trial has been granted by the Medical Ethical Committee of the Amsterdam University Medical Centres (loc. VUmc, ID NL60107.029.16). The primary results of this trial will be shared in a main article and subgroup analyses or spin-off studies will be shared in secondary papers.

Trial registration number

NCT03298659.

SUBMITTER: Beijnink CWH 

PROVIDER: S-EPMC7813313 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Instantaneous wave-free ratio guided multivessel revascularisation during percutaneous coronary intervention for acute myocardial infarction: study protocol of the randomised controlled iMODERN trial.

Beijnink Casper W H CWH   Thim Troels T   van der Heijden Dirk Jan DJ   Klem Igor I   Al-Lamee Rasha R   Vos Jacqueline L JL   Koop Yvonne Y   Dijkgraaf Marcel G W MGW   Beijk Marcel A M MAM   Kim Raymond J RJ   Davies Justin J   Raposo Luis L   Baptista Sérgio B SB   Escaned Javier J   Piek Jan J JJ   Maeng Michael M   van Royen Niels N   Nijveldt Robin R  

BMJ open 20210115 1


<h4>Introduction</h4>Recent randomised clinical trials showed benefit of non-culprit lesion revascularisation in ST-elevation myocardial infarction (STEMI) patients. However, it remains unclear whether revascularisation should be performed at the index procedure or at a later stage.<h4>Methods and analysis</h4>The instantaneous wave-free ratio (iFR) Guided Multivessel Revascularisation During Percutaneous Coronary Intervention for Acute Myocardial Infarction trial is a multicentre, randomised co  ...[more]

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