Actively Recruiting

Phase Not Applicable
Age: 19Years +
All Genders
ID04968808

Optimal Timing of Fractional Flow Reserve-Guided Complete Revascularization in Non-ST-Segment Elevation Myocardial Infarction (OPTION-NSTEMI)

Led by Chonnam National University Hospital · Updated on 2026-04-27

1014

Participants Needed

1

Research Sites

N/A

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating the best timing and strategy for revascularization in patients who have non-ST-segment elevation myocardial infarction (NSTEMI) with multivessel coronary artery disease (MVD), a condition linked to worse clinical outcomes. This trial compares immediate complete revascularization, where both the infarct-related artery (IRA) and other affected arteries are treated during the initial procedure, to a staged approach where the non-IRA is treated days later. The study aims to assess the safety and effectiveness of these two approaches, particularly using fractional flow reserve (FFR) to guide treatment for arteries with moderate narrowing.

CONDITIONS

Brief Title

Timing of FFR-guided PCI for Non-IRA in NSTEMI and MVD (OPTION-NSTEMI)

Who Can Participate

Age: 19Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age 19 years or older
  • Diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) with chest pain or equivalent ischemic symptoms
  • Elevated cardiac biomarkers indicating heart muscle injury
  • No ST-segment elevation on ECG or new left bundle branch block
  • Undergoing percutaneous coronary intervention (PCI) within 72 hours of symptoms
  • Multivessel coronary artery disease with at least one non-infarct artery showing 50% or more narrowing and diameter of 2.5 mm or greater
  • Agreement from patient or protector to participate and accept PCI risks
Not Eligible

You will not qualify if you...

  • Cardiogenic shock at presentation or after treatment of the infarct artery
  • Poor blood flow (TIMI flow 2 or less) in non-infarct arteries
  • Severe complications during PCI that prevent enrollment
  • Non-infarct artery lesions unsuitable for PCI
  • Chronic total occlusion in non-infarct arteries
  • History of allergic reaction to contrast agents
  • Pregnancy or breastfeeding
  • Life expectancy less than 1 year
  • Severe heart valve disease
  • History of or planned coronary artery bypass graft surgery (CABG)
  • Received fibrinolytic therapy before admission

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - Up to several days during hospitalization

Participants undergo percutaneous coronary intervention (PCI) for the infarct-related artery (IRA). They are then randomized to receive either immediate complete revascularization, where PCI for both IRA and non-infarct-related arteries (non-IRA) occurs during the same procedure, or staged complete revascularization, where PCI for non-IRA is performed during a separate hospital visit after the initial PCI. Non-IRA lesions with 50-69% diameter stenosis are evaluated using fractional flow reserve (FFR) to decide on PCI, while lesions with 70% or greater stenosis are treated without FFR evaluation.

1 to 2 visits (in-person) depending on treatment assignment

Follow-up

Duration - Up to 12 months

Participants are monitored for up to 12 months after treatment to assess clinical outcomes such as survival, revascularization events, and complications.

Periodic visits during 12-month follow-up

Trial Site Locations

Total: 1 location

1

Chonnam National University Hospital

Gwangju, South Korea

Actively Recruiting

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Research Team

M

Min Chul Kim, MD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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