NCT03298659: iMODERN

iFR Guided Multi-vessel Revascularization During Percutaneous Coronary Intervention for Acute Myocardial Infarction

Active, enrolled NA Last updated 4 April 2025

What this trial tests

NA trial testing iFR in Acute Myocardial Infarction in 1,146 participants. Participants enrolled and being followed up; not accepting new ones.

Timeline

21 December 2017

Primary endpoint
31 May 2025

31 May 2027

Quick facts

Lead sponsor	Radboud University Medical Center
Phase	NA
Status	Active, enrolled
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	none
Primary purpose	diagnostic
Enrollment	1,146
Start date	21 December 2017
Primary completion	31 May 2025
Estimated completion	31 May 2027
Sites	1 location across Netherlands

Drugs / interventions tested

• iFR
• CMR

Conditions studied

• Acute Myocardial Infarction — all drugs for Acute Myocardial Infarction →
• Multi Vessel Coronary Artery Disease — all drugs for Multi Vessel Coronary Artery Disease →

Sponsor

Radboud University Medical Center

Who can join

18 and older, any sex, with Acute Myocardial Infarction or Multi Vessel Coronary Artery Disease. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

In patients with acute ST-elevation myocardial infarction (STEMI), 40-60% have multi-vessel disease with an increased cardiovascular morbidity and mortality. Although it is not recommended to revascularize noninfarct lesions during the acute intervention, recent investigations suggest the opposite and show improved outcome after direct revascularization of noninfarct lesions. It is undesirable to risk procedure-related complications by treating noninfarct lesions without impaired flow. It is currently unknown whether pressure guided revascularization of noninfarct lesions in the acute phase improves outcome compared to the current guidelines.

The iMODERN trial aims to compare an iFR-guided intervention of noninfarct lesions during the acute intervention with a deferred stress perfusion CMR-guided strategy during the outpatient follow-up, to determine the optimal therapeutic approach for STEMI patients with multivessel lesions.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

1. Completeness of revascularisation in acute coronary syndrome patients with multivessel disease.
   Paradies V, Waldeyer C, Laforgia PL, Clemmensen P, et al · · 2021 · cited 12× · PMID 34167938 · DOI 10.4244/eij-d-20-00957
2. Instantaneous wave-free ratio and fractional flow reserve in clinical practice.
   Pisters R, Ilhan M, Veenstra LF, Gho BCG, et al · · 2018 · cited 11× · PMID 29923057 · DOI 10.1007/s12471-018-1125-1
3. Immediate versus staged revascularisation of non-culprit arteries in patients with acute coronary syndrome: a systematic review and meta-analysis.
   Vriesendorp PA, Wilschut JM, Diletti R, Daemen J, et al · · 2022 · cited 8× · PMID 35536483 · DOI 10.1007/s12471-022-01687-7
4. Instantaneous wave-free ratio guided multivessel revascularisation during percutaneous coronary intervention for acute myocardial infarction: study protocol of the randomised controlled iMODERN trial.
   Beijnink CWH, Thim T, van der Heijden DJ, Klem I, et al · · 2021 · cited 7× · PMID 33452200 · DOI 10.1136/bmjopen-2020-044035
5. Immediate or Deferred Nonculprit-Lesion PCI in Myocardial Infarction.
   Nijveldt R, Maeng M, Beijnink CWH, Piek JJ, et al · · 2026 · cited 5× · PMID 41159879 · DOI 10.1056/nejmoa2512918
6. Myocardial perfusion imaging in advanced coronary artery disease.
   Hoek R, van Diemen PA, Somsen YBO, de Winter RW, et al · · 2025 · cited 5× · PMID 40099580 · DOI 10.1111/eci.70024
7. Time course of coronary flow capacity impairment in ST-segment elevation myocardial infarction.
   van Lavieren MA, Stegehuis VE, Bax M, Echavarría-Pinto M, et al · · 2021 · cited 4× · PMID 32450714 · DOI 10.1177/2048872620918706
8. Management of Non-Culprit Lesions in STEMI Patients with Multivessel Disease.
   Piccolo R, Manzi L, Simonetti F, Leone A, et al · · 2023 · cited 3× · PMID 37048655 · DOI 10.3390/jcm12072572