Table 1

Comparison of FLOWER-MI with selected trials of non-culprit revascularisation after STEMI

FLOWER-MICOMPLETECompare-AcuteDANAMI-3-PRIMULTI
AngioFFR
Dates2016–20182011–20152011–20152011–2014
No of patients11714041885627
Median follow-up (mths)12361227
DesignAngio (>50%) vs FFRAngio (≥70%)* vs OMTFFR vs OMTFFR vs OMT
FFR ≥0.8044%46%31%
Composite primary outcome (no/%)Death, non-fatal MI, unplanned admission and urgent revascCV death, MI, ischaemia-driven revascDeath, non-fatal MI, any revasc, CVA/TIADeath, non-fatal MI, ischaemia-driven revasc
24 (4.2)32 (5.5)179 (8.9)23 (7.8)40 (13)
Event rate with revascularisation (%)†
 Death1.71.51.61.44.7
 CV deathNR1.01.01.6
 MI1.73.11.92.44.7
  • *Only a minority of patients with moderate stenoses (50%–69%) that would have mandated FFR measurement were enrolled in COMPLETE.

  • †Event rates for COMPLETE shown as % per person-year as reported by the authors, for comparison with the 12-month follow-up of FLOWER-MI.

  • COMPLETE, Complete versus Culprit-Only Revascularisation Strategies to Treat Multivessel Disease after Early PCI for STEMI; CV, cardiovascular; CVA, cerebrovascular accident; DANAMI-3-PRIMULTI, Third Danish Study of Optimal Acute Treatment of Patients with STEMI: Primary PCI in Multivessel Disease; FFR, fractional flow reserve; FLOWER-MI, FLOW Evaluation to Guide Revascularization in Multi-vessel ST-elevation Myocardial Infarction; MI, myocardial infarction; NR, not formally reported; OMT, optimal medical therapy; PCI, percutaenous coronary intervention; STEMI, ST-elevation myocardial infarction; TIA, transient ischaemic attack.