ArticleAmerican heart journal2020
Physiology-guided revascularization versus optimal medical therapy of nonculprit lesions in elderly patients with myocardial infarction: Rationale and design of the FIRE trial.
Article in American heart journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03772743 (Functional Versus Culprit-only Revascularization in Elderly Patients With Myocardial Infarction and Multivessel Disease), which is not on this map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Functional Versus Culprit-only Revascularization in Elderly Patients With Myocardial Infarction and Multivessel Disease
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- 30-Day DAPT in Patients at High Bleeding Risk Undergoing PCI With Biodegradable-Polymer Sirolimus-Eluting Ultra-Thin Stent.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Pooled it
- Unsolved Questions in the Revascularization of Older Myocardial Infarction Patients with Multivessel Disease.Reviews in cardiovascular medicine · 2022Pooled it
- Multivessel vs. Culprit Vessel-Only Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction in Patients With Cardiogenic Shock: An Updated Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Diabetes does not attenuate the benefit of physiology-guided complete revascularization in older patients with myocardial infarction.Cardiovascular diabetology · 2026Trial
- Impact of Complete Revascularization on Development of Heart Failure in Patients With Acute Coronary Syndrome and Multivessel Disease: A Subanalysis of the CORALYS Registry.Journal of the American Heart Association · 2023Trial
- Complete revascularization and heart failure risk in acute coronary syndrome across the ejection fraction spectrum: focus on LVEF-dependent effects.Frontiers in cardiovascular medicine · 2026Article
- Physiology-Guided Complete Revascularization in Older Patients With Myocardial Infarction: Three-Year Outcomes of a Randomized Clinical Trial.JAMA cardiology · 2025Article
- Effect of complete revascularization in acute coronary syndrome after 75 years old: insights from the BleeMACS registry.Journal of geriatric cardiology : JGC · 2023Article
- Revascularization Modalities in Acute Coronary Syndrome: A Review of the Current State of Evidence.Cureus · 2023Review
- Comparison of long-term outcomes of complete vs. incomplete revascularization in elderly patients (≥75 years) with acute coronary syndrome and multi-vessel disease undergoing percutaneous coronary intervention.Frontiers in cardiovascular medicine · 2023Article
- Multivessel versus Culprit-Only Percutaneous Coronary Intervention in Patients with Non-ST-Elevation Acute Coronary Syndrome.Journal of clinical medicine · 2022Article
- Ultrathin Struts Drug-Eluting Stents: A State-of-the-Art Review.Journal of personalized medicine · 2022Review
- Twelve months clinical outcomes of ultrathin strut sirolimus-eluting stent in real-world Indian patients with coronary artery disease.American journal of cardiovascular disease · 2022Article
- Quantitative Flow Ratio Is Associated with Extent and Severity of Ischemia in Non-Culprit Lesions of Patients with Myocardial Infarction.Journal of clinical medicine · 2021Article
- Physiologic Assessment of Coronary Stenosis: Current Status and Future Directions.Current cardiology reports · 2021Review
- Contrast Associated Acute Kidney Injury and Mortality in Older Adults with Acute Coronary Syndrome: A Pooled Analysis of the FRASER and HULK Studies.Journal of clinical medicine · 2021Article
- Functionally Complete Coronary Revascularisation in Patients Presenting with ST-elevation MI and Multivessel Coronary Artery Disease.Interventional cardiology (London, England) · 2021Review
- Fractional Flow Reserve: Patient Selection and Perspectives.Vascular health and risk management · 2021Review
Corrections and comments
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Authors and funding
24 authors at 15 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMyocardial infarction (MI) in elderly patients is associated with unfavorable prognosis, and it is becoming an increasingly prevalent condition. The prognosis of elderly patients is equally impaired in ST-segment elevation (STE) or non-STE (NSTE), and it is markedly worsened by the common presence of multivessel disease (MVD). Given the limited evidence available for elderly patients, it has not yet been established whether, as for younger patients, a complete revascularization strategy in MI patients with MVD should be advocated. We present the design of a dedicated study that will address this research gap. METHODS AND
designThe FIRE trial is a prospective, randomized, international, multicenter, open-label study with blinded adjudicated evaluation of outcomes. Patients aged 75 years and older, with MI (either STE or NSTE), MVD at coronary artery angiography, and a clear culprit lesion will be randomized to culprit-only treatment or to physiology-guided complete revascularization. The primary end point will be the patient-oriented composite end point of all-cause death, any MI, any stroke, and any revascularization at 1 year. The key secondary end point will be the composite of cardiovascular death and MI. Quality of life and physical performance will be evaluated as well. All components of the primary and key secondary outcome will be tested also at 3 and 5 years. The sample size for the study is 1,400 patients. IMPLICATIONS: The FIRE trial will provide evidence on whether a specific revascularization strategy should be applied to elderly patients presenting MI and MVD to improve their clinical outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.