{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T04:04:02Z","timestamp":1774065842628,"version":"3.50.1"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The FIRE trial (Functional Assessment in Elderly Myocardial Infarction Patients With Multivessel Disease) enrolled 1445 older (aged \u226575 years) patients with myocardial infarction and multivessel disease in Italy, Spain, and Poland. Patients were randomized to physiology-guided complete revascularization or treatment of the only culprit lesion. Physiology-guided complete revascularization significantly reduced ischemic adverse events at 1 year. This prespecified analysis investigated the changes between the 2 study groups in angina status, quality of life, physical performance, and frailty.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Patients underwent validated scales at hospital discharge (baseline) and 1 year later. Angina status was evaluated using the Seattle Angina Questionnaire, health-related quality of life by EQ visual analog scale, physical performance by short physical performance battery, and frailty by the clinical frailty scale. Mixed models for repeated measures analysis were used to study the association between the treatment arms, time, and scales.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Baseline and 1-year Seattle Angina Questionnaire, EQ visual analog scale, short physical performance battery, and clinical frailty scale were collected in around two-thirds of the entire FIRE study population. The mean age was 80.9\u00b14.6 years (female sex, 35.9%). Overall, 35.3% were admitted for ST-segment\u2013elevation myocardial infarction, whereas the others were admitted for non\u2013ST-segment\u2013elevation myocardial infarction. Physiology-guided complete revascularization, compared with culprit-only revascularization, was associated with greater improvement in terms of angina status (Seattle Angina Questionnaire summary score, 7.3 [95% CI, 6.1\u20138.6] points), health-related quality of life (EQ visual analog scale, 6.2 [95% CI, 4.4\u20138.1] points), and physical performance (short physical performance battery, 1.1 [95% CI, 0.9\u20131.3] points). After 1 year, patients randomized to culprit-only revascularization experienced a deterioration in frailty status (clinical frailty scale, 0.2 [95% CI, 0.1\u20130.3] points), which was not observed in patients randomized to physiology-guided complete revascularization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The present analysis suggested that a physiology-guided complete revascularization is associated with consistent benefits in terms of angina status, quality of life, physical performance, and the absence of further deterioration of the frailty status.<\/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: NCT03772743.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.123.010490","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T09:00:55Z","timestamp":1718701255000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Health-Status Outcomes in Older Patients With Myocardial Infarction: Physiology-Guided Complete Revascularization Versus Culprit-Only Strategy"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct03772743","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5150-188X","authenticated-orcid":true,"given":"Gianluca","family":"Campo","sequence":"first","affiliation":[{"name":"Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Italy (G. Campo, S.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0833-2785","authenticated-orcid":true,"given":"Vincenzo","family":"Guiducci","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Unit\u00e0 Sanitaria Locale - Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, S. Maria Nuova Hospital, Italy (V.G., S.M.d.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4932-0112","authenticated-orcid":true,"given":"Javier","family":"Escaned","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos Istituto de Investigacion Sanitaria Hospital San Carlos, Complutense University of Madrid, Spain (J.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul","family":"Moreno","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Cardiovasculares, Madrid, Spain (R.M.)."},{"name":"Instituto de Investigaci\u00f3n Hospital La Paz, University Hospital La Paz, Madrid, Spain (R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0701-7329","authenticated-orcid":true,"given":"Gianni","family":"Casella","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Ospedale Maggiore, Bologna, Italy (G. Casella, A.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Cavazza","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Infermi Hospital, Rimini, Italy (C.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1260-7534","authenticated-orcid":true,"given":"Enrico","family":"Cerrato","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, and Rivoli Infermi Hospital ASLTO3, Turin, Italy (E.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Contarini","sequence":"additional","affiliation":[{"name":"Ospedale Santa Croce, Moncalieri, Italy (A.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9768-3359","authenticated-orcid":true,"given":"Marco","family":"Arena","sequence":"additional","affiliation":[{"name":"S.C. Cardiologia, Ospedale Sant\u2019Andrea, La Spezia, Italy (M.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7758-6252","authenticated-orcid":true,"given":"Andres","family":"Iniguez Romo","sequence":"additional","affiliation":[{"name":"Hospital Alvaro Conqueiro de Vigo, Spain (A.I.R.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6405-8581","authenticated-orcid":true,"given":"Enrique","family":"Guti\u00e9rrez Iba\u00f1es","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Maranon, Madrid, Spain (E.G.I.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5916-8882","authenticated-orcid":true,"given":"Roberto","family":"Scarsini","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero Universitaria Integrata di Verona, Italy (R.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0869-4855","authenticated-orcid":true,"given":"Giuseppe","family":"Vadal\u00e0","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone, Italy (G.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5552-6382","authenticated-orcid":true,"given":"Giuseppe","family":"And\u00f2","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero Universitaria Policlinico Gaetano Martino, Messina, Italy (G.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6318-3180","authenticated-orcid":true,"given":"Gerlando","family":"Pilato","sequence":"additional","affiliation":[{"name":"Hospital San Giovanni di Dio, Azienda Sanitaria Provinciale Agrigento, Italy (G.P.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Musto d\u2019Amore","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Unit\u00e0 Sanitaria Locale - Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, S. Maria Nuova Hospital, Italy (V.G., S.M.d.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Capecchi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Ospedale Maggiore, Bologna, Italy (G. 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