DANAMI3: Primary Angioplasty to culprit vessel versus multivessel guided by FFR

The aim of this study was to compare the usefulness of primary angioplasty only to culprit vessel versus complete revascularization guided by fractional flow reserve (FFR) in patients admitted pursuing an acute myocardial infarction with ST-segment elevation and have multiple injuries vessels. After a successful primary angioplasty to culprit artery, patients were randomized 1:1 to continue with medical treatment (n = 313) or full-driven revascularization guided by FFR, before discharge (n = 314). The mean time between primary angioplasty and angioplasty to other vessels was 2 days and in 93% of patients drug-eluting stents were used. Follow-up was 27 months.

The combined primary end point (death from any cause, myocardial infarction, ischemia-driven revascularization of the not guilty vessel) was 22% for angioplasty only to the culprit artery and 13% to multiple vessels with FFR (p = 0.004). The benefit was similar primarily by less ischemia-driven revascularization in not guilty vessels (5% versus 17%, p <0.001), with mortality (5% versus 4%, p = 0.43) and nonfatal myocardial infarction (5% versus 5%, p = 0.87).

Conclusion

Patients with multivessel entering pursuing an ST segment myocardial infarction and receive a successful primary angioplasty benefit of the angioplasty to the rest of the vessels guided by FFR before discharge.

Thomas Engstrom
2015-03-18

Original title: The Third DANish Study of Optimal Acute Treatment of Patients With STEMI: PRImary PCI in MULTIvessel Disease Clinical Trial – DANAMI3- PRIMULTI.

More articles by this author

TOTAL: The thromboaspiration provides no benefit in primary angioplasty

In patients undergoing ST segment elevation myocardial infarction (STEMI) who received primary angioplasty, the strategy of manual thromboaspiration routine does not reduce the risk...

MATRIX: The radial access reduces events, bivalirudin with mixed results

Two separate works are part of the MATRIX study investigating strategies to reduce bleeding and mortality in patients with acute coronary syndrome. The first...

IMPROVE-IT: The combination simvastatin / ezetimibe reduces post SCA events

This work included 18144 patients from 39 countries that were admitted pursuing an acute coronary syndrome (with or without ST segment elevation) randomized 1:...

BEST: Similar mortality among angioplasty with DES (everolimus) and surgery

This observational registry compared the results of myocardial revascularization with angioplasty performed using everolimus-eluting stents in patients with multivessel. The primary endpoint of the...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Evolution of Small Balloon-Expandable Valves

Small aortic rings (20 mm) have posed a significant challenge for both surgery and transcatheter aortic valve implantation (TAVI) due to their association with an...

TCT 2024 | Asymptomatic Severe Aortic Stenosis: What Should Be our Approach?

Approximately 3% of the population over 65 years old has aortic stenosis. Current guidelines recommend valve replacement for patients with symptoms or an ejection...

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...