OPtimal TIming of Fractional Flow Reserve-Guided Complete RevascularizatiON for Non-Infarct Related Artery in Non-ST-Segment Elevation Myocardial Infarction with Multivessel Disease (OPTION-NSTEMI)

Chonnam National University Hospital0 个研究点目标入组 676 人开始时间: 待定最近更新: 2024年1月22日

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•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

•1) Cardiogenic shock at initial presentation or after treatment of infarct-related artery(IRA)*
•2) Thrombolysis in Myocardial Infarction(TIMI) flow at non-IRA = 2 at initial coronary angiography
•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 percutaneous coronary intervention(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 due to non-cardiac disease
•9) Severe valvular disease
•10) History of coronary artery bypass graft(CABG), or planned CABG
•11) Severe asthma
•12) Patient's refusal for study participation
•* The definition of cardiogenic shock
•1) Systolic blood pressure(SBP) < 90mmHg for more than 30min, or needs for vasopressor to maintain equal or more than SBP 90mmHg
•2) Pulmonary congestion, or increased left ventricular filling pressure by cardiac catheterization
•3) At least one sign of impaired organ perfusion: mental obtundation, pallor, coldness, oliguria, increased blood lactate

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