Many patients with non-ST-segment elevation myocardial infarction (NSTEMI) have multivessel coronary artery disease (MVD), which is associated with poor clinical outcomes. However, there have been few studies regarding revascularization strategy in patients with NSTEMI and MVD. Therefore, we planned to perform prospective, open-label, randomized trial to evaluate the efficacy and safety of immediate complete revascularization (percutaneous coronary intervention \[PCI\] for both infarct-related artery \[IRA\] and non-IRA during index PCI) compared to staged PCI strategy of non-IRA (PCI for IRA followed by non-IRA PCI after several days). PCI procedure at non-IRA with diameter stenosis between 50 and 69% should be conducted with the aid of fractional flow reserve (FFR), and non-IRA with diameter stenosis ≥ 70% will be revascularized without FFR.
Age ≥ 19 years old
Non-ST-segment elevation myocardial infarction
Angina pectoris or equivalent ischemic chest discomfort with at least 1 of 3 features and,
occurs at rest, usually lasting > 10 minutes
Cardiogenic shock at initial presentation or after treatment of IRA
TIMI flow at non-IRA ≤ 2
Severe procedural complications (e.g. persistent no-reflow phenomenon, coronary artery perforation) which restricts study enrollment by operators' decision
Non-IRA lesion not suitable for PCI treatment by operators' decision