Table 2

Selected ongoing trials evaluating the timing, completeness and revascularisation strategies in patients presenting with ACS

StudyNCT numberDesignClinical settingTreatment groupControl groupPrimary outcomeIncluded patients (N)Completion date*
BIOVASC03621501Multicentre open-label non-inferiority RCTPatients with STEMI and NSTEACS with MVDImmediate complete revascularisation (angiography/physiology guided)Staged complete revascularisation (angiography/physiology guided)All-cause death, MI, unplanned ischaemia-driven revascularisation and cerebrovascular events15252021
FIRE03772743Multicenter prospective open-label RCTPatients with STEMI and NSTEACS MVD aged ≥75 yearsFunctional complete revascularisationIRA-only revascularisationAll-cause death, any MI, stroke or coronary revascularisation13852021
FULL-REVASC02862119Multicentre prospective open-label RCTSTEMI/very high-risk NSTEACS with MVDFFR-guided complete revascularisation during index hospital admissionConservative management of non-culprit lesions during index hospital admissionAll-cause death and MI40522021
iMODERN03298659Multicentre prospective open-label RCTPatients with STEMI with MVDImmediate iFR-guided complete revascularisationDeferred stress perfusion CMR-guided revascularisationAll-cause death, MI and hospitalisation for HF11462021
OPTION STEMI04626882Multicentre prospective open-label RCTPatients with STEMI with MVDImmediate FFR revascularisation of non-IRA lesions with diameter stenosis 50%–70% by visual estimation†In-hospital FFR revascularisation of non-IRA lesions with diameter stenosis 50%–70% by visual estimation†All-cause death, MI or unplanned revascularisation7842024
Quantitative fractional ratio-guided revascularisation04259853Multicenter prospective RCTPatients with STEMI with MVDQFR-guided complete revascularisationAngiography-guided complete revascularisationAll-cause death, MI, any revascularisation, hospitalisation for HF, stroke or major bleeding10162022
RAPID-NSTEMI03707314Multicentre prospective open-label RCTHigh-risk patients with NSTEACSImmediate angiographyStandard of care angiographyAll-cause death, MI and admission for HF23142021
SAFE STEMI for Seniors02939976Multicentre prospective unblinded RCTPatients with STEMI aged ≥60 yearsiFR-guided complete revascularisationIRA-only revascularisationCvLPRIT-MACE‡
Infarct-related artery MACE§
lSENIOR-RITA03052036Multicentre prospective open-label RCTPatients with type I NSTEACS aged ≥75 yearsInvasive angiography and coronary revascularisationOptimal medical therapyCV death or non-fatal MI16682022
SLIM03562572Multicentre prospective RCTPatients with NSTEACS with MVDImmediate FFR-guided complete revascularisationUsual care non-IRA lesions by discretion of the physicianAll-cause death, MI, any revascularisation and stroke4142021
  • *Estimated primary completion date.

  • †Non-IRA lesion which have ≥70% diameter stenosis by visual estimation will be revascularised without FFR evaluation.

  • ‡CvLPRIT MACE: all-cause mortality, recurrent MI, heart failure (requiring hospitalisation or 12-hour emergency room visit) or ischaemia-driven revascularisation for all treated arteries.

  • §Infarct-related artery MACE: cardiac death, infarct artery target-vessel MI, or ischaemia-driven index infarct-related vessel revascularisation by percutaneous or surgical methods.

  • CMR, cardiovascular magnetic resonance; CV, cardiovascular; CvLPRIT, Complete Versus Lesion-Only Primary PCI Trial; FFR, fractional flow reserve; HF, heart failure; iFR, instantaneous wave-free ratio; IRA, infarct-related artery; MACE, major adverse cardiac event; MI, myocardial infarction; MVD, multivessel disease; NCT, National Clinical Trial; NSTEACS, non-ST-segment elevation acute coronary syndrome; RCT, randomised controlled trial; STEMI, ST-segment elevation myocardial infarction.