Philips Study Finds Treating All Blocked Arteries During First Heart Attack Procedure Is Safe and Effective

Author: Benzinga Newsdesk | October 29, 2025 05:09am

Royal Philips (NYSE:PHG, AEX: PHIA))), a global leader in health technology, today announced late-breaking results from the iMODERN trial (Instantaneous wave-free Ratio Guided Multivessel Revascularisation During PCI for Acute Myocardial Infarction) at the Transcatheter Cardiovascular Therapeutics (TCT) 2025 conference, the world's leading meeting for interventional cardiology. The study compared immediate versus delayed treatment of additional narrowed arteries in heart attack patients to determine whether treating all blockages in one procedure is as safe and effective as waiting for a follow-up procedure. The study compared immediate versus 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 – a key question, since many patients have multiple diseased arteries and the optimal timing for complete treatment remains uncertain.

In today's practice, when patients suffer a serious type of heart attack (STEMI), cardiologists urgently open the blocked artery causing the attack. But many of these patients also have disease in other arteries. Often these additional narrowed arteries are not treated right away, either due to time restraints, patient stability, resource constraints or because they stay unnoticed. They may be treated later in a separate hospital stay or not at all, leaving uncertainty about the best timing and approach.

The new findings show that patients can safely have additional arteries treated immediately during the first procedure to treat the acute event, rather than during a later second intervention. By confirming the safety of extending Class I, Level A-recommended iFR to non-stable patients, the results offer physicians the opportunity to complete treatment in one session, without compromising long-term outcomes. The iMODERN trial is the largest study to date testing iFR* in the acute heart attack setting, expanding the evidence base for a tool already strongly recommended (Class I, Level A) in stable patients.

The findings are published in The New England Journal of Medicine (NEJM), underscoring its global scientific significance and impact on cardiology practice.

"These results address one of the longest-standing questions in interventional cardiology," said Prof. Niels van Royen, co-principal investigator, Radboud University Medical Center, The Netherlands. "Measuring and eventually treating additional arteries can be performed during the first procedure or during a staged procedure. That means cardiologists can feel confident offering patients a complete solution in one sitting when it's appropriate."

The iMODERN study enrolled 1,146 patients across 41 hospitals in 14 countries directly addressed this question. Patients were randomly assigned to one of two treatment strategies: either immediate physiology-guided treatment of additional narrowed arteries during the first procedure using instantaneous wave-free ratio (iFR), or staged treatment guided by cardiac Magnetic Resonance Imaging (MRI) carried out within four days to six weeks after the heart attack. The study's main endpoint combined three outcomes: death, another heart attack, or hospitalization for heart failure over three years. After three years of follow-up, the trial found no significant difference in major outcomes – including death, repeat heart attack, or hospitalization for heart failure – between the two approaches. By confirming that both approaches are backed by solid evidence, the trial offers patients more certainty and more personalized care.

"Flexibility is critical in real-world practice," added Prof. Dr. Robin Nijveldt, co-principal investigator, at Radboud University Medical Center, in the Netherlands. "Some patients may benefit from immediate treatment, while others are better served by waiting. iMODERN is a pragmatic study that shows that an immediate intervention is not necessarily better than waiting, if patients are offered a CMR to evaluate the need for a second intervention, giving physicians the evidence they need to tailor decisions to each patient."

"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."

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