6/28/23, 1:14 AM DANAMI-3 PRIMULTI Pathway Feedback Search Clinical Topics Home Studies DANAMI 3 PRIMULTI DANAMI 3 PRIMULTI Disease Disease Coronary artery disease ST-elevation myocardial infarction Trial question What is the role of fractional flow reserve-guided complete revascularization in patients with acute ST-segment elevation myocardial infarction and multivessel coronary disease? Study design Multi-center Open label RCT Population Characteristics of study participants 19.0% female N = 627 81.0% male 627 patients (121 female, 506 male) Inclusion criteria: patients with acute ST-segment elevation myocardial infarction (STEMI) who had 1 clinically significant coronary stenosis in addition to the lesion in the infarct-related artery Key exclusion criteria: intolerance of contrast media or of relevant anticoagulant or antithrombotic drugs, unconsciousness or cardiogenic shock, stent thrombosis, indication for CABG, or increased bleeding risk Interventions N=314 complete revascularization (guided by fractional flow reserve after primary PCI) N=313 no further invasive treatment (PCI of infarct-related artery only) https://web.pathway.md/studies/recUAchxUTPV1dgNL 1/2 6/28/23, 1:14 AM DANAMI-3 PRIMULTI Pathway Primary outcome All-cause death, nonfatal reinfarction, and ischemia-driven revascularization of lesions in noninfarct- related arteries 22.0 % 22 16.5 % 13 11.0 % Significant decrease 5.5 % NNT = 11 0.0 % Complete revascularization No further invasive treatment Significant decrease in all-cause death, nonfatal reinfarction, and ischemia-driven revascularization of lesions in noninfarct-related arteries (13% vs. 22%; HR 0.56, 95% CI 0.38 to 0.83) Secondary outcomes Significant decrease in nonurgent PCI (3% vs. 9%; HR 0.29, 95% CI 0.13 to 0.63) Conclusion In patients with acute ST-segment elevation myocardial infarction (STEMI) who had 1 clinically significant coronary stenosis in addition to the lesion in the infarct-related artery, complete revascularization was superior to no further invasive treatment with respect to a all-cause death, nonfatal reinfarction, and ischemia-driven revascularization of lesions in noninfarct-related arteries. Reference Engstrom T, Kelbaek H, Helqvist S et al. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3-PRIMULTI): an open-label, randomised controlled trial. Lancet. 2015 Aug 15;386(9994):665-71. Open reference URL https://web.pathway.md/studies/recUAchxUTPV1dgNL 2/2