ASSIST Trial Comparing Anatomic and Physiologic Guidance for Complete Revascularization Using Drug-Eluting Stents in Patients with Coronary Artery Disease

What this Trial Is About

Researchers are evaluating two different strategies for complete revascularization in patients with significant coronary artery disease CAD who are undergoing percutaneous coronary intervention PCI with drug-eluting stents DES. The study compares quantitative coronary angiography QCA-guided anatomic complete revascularization and fractional flow reserve FFR-guided physiologic complete revascularization. This prospective, multicenter, randomized trial includes patients with symptoms or evidence of myocardial ischemia and specific stenotic lesions in major coronary arteries. Participants are randomly assigned to either the QCA-guided group, where PCI is performed on lesions with at least 50% diameter stenosis, or the FFR-guided group, where PCI targets lesions with FFR values of 0.80 or less. Imaging guidance during PCI is optional but left to the operators discretion, while routine high-pressure post-dilation is recommended. The study involves an initial procedure with possible staged procedures as needed. Participants will be followed clinically at 1, 6, and 12 months, and then up to 5 years after the initial procedure. Assessments include tracking death, myocardial infarction, unplanned repeat revascularization, bleeding, rehospitalization, and self-rated health. The study aims to collect data on these outcomes to compare the two revascularization strategies in terms of safety, efficacy, and cost-effectiveness over both short- and long-term periods.

Anatomic Versus Physiologic Guidance for Complete Revascularization With DES Eluting in Patients With CAD