Philips Data Supports Immediate Narrowed Artery Treatment for Heart Attacks

Philips released late-breaking results from its iMODERN trial (Instantaneous wave-free Ratio Guided Multivessel Revascularisation During PCI for Acute Myocardial Infarction) at this year’s Transcatheter Cardiovascular Therapeutics (TCT) conference.

The study compared immediate vs. deferred treatment of additional narrowed arteries in heart attack patients to determine whether treating all blockages in a single procedure is superior to waiting for a follow-up procedure. Many patients have multiple disease arteries, and the best timing for complete treatment is uncertain.

Philips said findings show patients can safely have additional arteries treated immediately during the initial procedure to treat the acute event, instead of a later second intervention. The findings confirmed the safety of extended Class I, Level A-recommended iFR (instantaneous wave-free ratio) to non-stable patients.

iMODERN is the largest study to date testing iFR for acute heart attacks. It enrolled 1,146 patients at 41 hospitals in 14 countries. Patients were randomly assigned to either immediate physiology-guided treatment of additional narrowed arteries during the first procedure using iFR, or staged treatment guided by cardiac MRI carried out within four days to six weeks after the heart attack.

The study’s main endpoint combined the three outcomes of death, another heart attack, or hospitalization for heart failure over three years. The trial found no significant difference in major outcomes between the two approaches.

“These results complement current international guideline recommendations (Class I recommendation, Level A evidence) for complete revascularization in STEMI,” said Dr. Darshan Doshi, practicing interventional cardiologist and Head of Medical & Clinical at Philips Image-Guided Therapy Devices. “By integrating physiological assessment, iMODERN’s evidence demonstrates that cardiologists can follow these findings for full revascularization while also tailoring treatment to each vessel’s true ischemic relevance.”

Related findings from the ILIAS ANOCA (Inclusive Invasive Physiological Assessment in Angina Syndromes – Angina with No Obstructive Coronary Artery Disease) were also presented at TCT. The study demonstrated the value of physiology-guided decisions in patients with angina and no obstructive coronary arteries (ANOCA). The study assessed the impact of coronary function testing (CFT) in patients whose coronary arteries appear unobstructed on angiography but who continue to experience angina.

The trial compared standard care with CFT-guided medical therapy using Philips Doppler FloWire and FloMap systems. Ad-hoc CFT followed by tailored therapy was found to significantly improve patient-reported angina symptoms and quality of life at six months. Philips said these results confirm and extend earlier CorMiCA findings, supporting CFT as a Class I, Level A recommendation in ANOCA patients and showing the potential of Philips Doppler technology to guide individualized treatment strategies safely and effectively.