{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:09:45Z","timestamp":1791410985619,"version":"4.3.3"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>In patients with multivessel disease with successful primary percutaneous coronary intervention for ST-segment\u2013elevation myocardial infarction, the FLOWER-MI trial (Flow Evaluation to Guide Revascularization in Multivessel ST-Elevation Myocardial Infarction) showed that a fractional flow reserve (FFR)\u2013guided strategy was not superior to an angiography-guided strategy for treatment of noninfarct-related artery lesions regarding the 1-year risk of death from any cause, myocardial infarction, or unplanned hospitalization leading to urgent revascularization. The extension phase of the trial was planned using the same primary outcome to determine whether a difference in outcomes would be observed with a longer follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In this multicenter trial, we randomly assigned patients with ST-segment\u2013elevation myocardial infarction and multivessel disease with successful percutaneous coronary intervention of the infarct-related artery to receive complete revascularization guided by either FFR (n=586) or angiography (n=577).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      After 3 years, a primary outcome event occurred in 52 of 498 patients (9.40%) in the FFR-guided group and in 44 of 502 patients (8.17%) in the angiography-guided group (hazard ratio, 1.19 [95% CI, 0.79\u20131.77];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.4). Death occurred in 22 patients (4.00%) in the FFR-guided group and in 23 (4.32%) in the angiography-guided group (hazard ratio, 0.96 [95% CI, 0.53\u20131.71]); nonfatal myocardial infarction in 23 (4.13%) and 14 (2.56%), respectively (hazard ratio, 1.63 [95% CI, 0.84\u20133.16]); and unplanned hospitalization leading to urgent revascularization in 21 (3.83%) and 18 (3.36%; hazard ratio, 1.15 [95% CI, 0.61\u20132.16]), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Although event rates in the trial were lower than expected, in patients with ST-segment\u2013elevation myocardial infarction undergoing complete revascularization, an FFR-guided strategy did not have a significant benefit over an angiography-guided strategy with respect to the risk of death, myocardial infarction, or urgent revascularization up to 3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT02943954.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.123.013913","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T05:00:34Z","timestamp":1716526834000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Three-Year Outcomes With Fractional Flow Reserve\u2013Guided or Angiography-Guided Multivessel Percutaneous Coronary Intervention for Myocardial Infarction"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct02943954","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0533-9682","authenticated-orcid":true,"given":"Etienne","family":"Puymirat","sequence":"first","affiliation":[{"name":"Department of Cardiology, Assistance Publique-H\u00f4pitaux de Paris (AP-HP), H\u00f4pital europ\u00e9en Georges Pompidou, France (E.P., D.B., N.D.)."},{"name":"Universit\u00e9 de Paris, France (E.P., D.B., N.D., G.D.)."},{"name":"French Alliance for Cardiovascular Trials, Paris, France (E.P., T.S., P.G.S., G.L., G.D., N.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6449-4826","authenticated-orcid":true,"given":"Guillaume","family":"Cayla","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de N\u00eemes, France (G.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4550-0450","authenticated-orcid":true,"given":"Tabassome","family":"Simon","sequence":"additional","affiliation":[{"name":"French Alliance for Cardiovascular Trials, Paris, France (E.P., T.S., P.G.S., G.L., G.D., N.D.)."},{"name":"Department of Clinical Pharmacology, AP-HP, H\u00f4pital Saint Antoine, Unit\u00e9 de Recherche Clinique, France (T.S.)."},{"name":"Universit\u00e9 Pierre et Marie Curie (UPMC-Paris 06), INSERM U-698, Paris, France (T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-2941","authenticated-orcid":true,"given":"Philippe Gabriel","family":"Steg","sequence":"additional","affiliation":[{"name":"French Alliance for Cardiovascular Trials, Paris, France (E.P., T.S., P.G.S., G.L., G.D., N.D.)."},{"name":"Universit\u00e9 de Paris, INSERM Unit\u00e9-1148, H\u00f4pital Bichat, Assistance Publique-H\u00f4pitaux de Paris, France (P.G.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0824-6809","authenticated-orcid":true,"given":"Gilles","family":"Montalescot","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, ACTION Study Group, Institut de Cardiologie (APHP), INSERM UMRS 1166, Paris, France (G.M., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4078-1476","authenticated-orcid":true,"given":"Isabelle","family":"Durand-Zaleski","sequence":"additional","affiliation":[{"name":"Clinical Research Unit Eco Ile de France, H\u00f4pital H\u00f4tel Dieu, AP-HP, France (I.D.-Z., F.N.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola","family":"Ngaleu Siaha","sequence":"additional","affiliation":[{"name":"Clinical Research Unit Eco Ile de France, H\u00f4pital H\u00f4tel Dieu, AP-HP, France (I.D.-Z., F.N.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Gallet","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, APHP, H\u00f4pitaux Universitaires Henri Mondor, Cr\u00e9teil, France (R.G.)."},{"name":"U955-IMRB, Equipe 03, Inserm, Univ Paris Est Creteil, \u00c9cole Nationale V\u00e9t\u00e9rinaire D\u2019Alfort, Maisons-Alfort, France (R.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalife","family":"Khalife","sequence":"additional","affiliation":[{"name":"H\u00f4pital du Bon Secours, Metz, France (K.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Morelle","sequence":"additional","affiliation":[{"name":"Clinique St. Martin, Caen, France (J.-F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Motreff","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CHU Clermont-Ferrand, CNRS, UMR 6602, Universit\u00e9 Clermont Auvergne, France (P.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2917-9273","authenticated-orcid":true,"given":"Gilles","family":"Lemesle","sequence":"additional","affiliation":[{"name":"French Alliance for Cardiovascular Trials, Paris, France (E.P., T.S., P.G.S., G.L., G.D., N.D.)."},{"name":"Cardiac Intensive Care Unit, Heart and Lung Institute, CHU Lille, France (G.L.)."},{"name":"Heart and Lung Institute, University Hospital of Lille, Institut Pasteur of Lille, Inserm, France (G.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0604-1976","authenticated-orcid":true,"given":"Jean-Guillaume","family":"Dillinger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, H\u00f4pital Lariboisi\u00e8re, AP-HP, Inserm U-942, Universit\u00e9 de Paris, France (J.-G.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4260-2339","authenticated-orcid":true,"given":"Thibault","family":"Lhermusier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France (T.L.)."},{"name":"Medical School, Toulouse III Paul Sabatier University, France (T.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1901-2808","authenticated-orcid":true,"given":"Johanne","family":"Silvain","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, ACTION Study Group, Institut de Cardiologie (APHP), INSERM UMRS 1166, Paris, France (G.M., J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1291-4024","authenticated-orcid":true,"given":"Vincent","family":"Roule","sequence":"additional","affiliation":[{"name":"Cardiology Department, Caen University Hospital, France (V.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Noel","family":"Lab\u00e8que","sequence":"additional","affiliation":[{"name":"GCS de Cardiologie de la C\u00f4te Basque, CH Bayonne, France (J.-N.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7073-354X","authenticated-orcid":true,"given":"Gr\u00e9goire","family":"Rang\u00e9","sequence":"additional","affiliation":[{"name":"Cardiology Department, Les H\u00f4pitaux de Chartres, France (G.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4069-1128","authenticated-orcid":true,"given":"Gr\u00e9gory","family":"Ducrocq","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, France (E.P., D.B., N.D., G.D.)."},{"name":"French Alliance for Cardiovascular Trials, Paris, France (E.P., T.S., P.G.S., G.L., G.D., N.D.)."},{"name":"Department of Cardiology, H\u00f4pital Bichat, Assistance Publique-H\u00f4pitaux de Paris, French Alliance for Cardiovascular Trials, INSERM U1148, Laboratory for Vascular Translational Science, France (G.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5176-5121","authenticated-orcid":true,"given":"Yves","family":"Cottin","sequence":"additional","affiliation":[{"name":"Physiopathologie et Epid\u00e9miologie C\u00e9r\u00e9bro-Cardiovasculaires, EA 7460, University of Bourgogne Franche-Comt\u00e9, Dijon, France (Y.C.)."},{"name":"Cardiology Department, University Hospital Centre of Dijon Bourgogne, Dijon, France (Y.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Blanchard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Assistance Publique-H\u00f4pitaux de Paris (AP-HP), H\u00f4pital europ\u00e9en Georges Pompidou, France (E.P., D.B., N.D.)."},{"name":"Universit\u00e9 de Paris, France (E.P., 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