Late-breaking iMODERN findings presented at TCT 2025 and published in the New England Journal of Medicine highlight new evidence to guide treatment choices for heart attack patients

Core Insights - Royal Philips announced results from the iMODERN trial, which evaluated the safety and effectiveness of immediate versus delayed treatment of additional narrowed arteries in heart attack patients [1][3][5] - The study found no significant difference in major outcomes between immediate treatment during the first procedure and staged treatment, providing evidence for both approaches [3][5][13] Group 1: iMODERN Trial Findings - The iMODERN trial is the largest study to date testing instantaneous wave-free ratio (iFR) in acute heart attack settings, enrolling 1,146 patients across 41 hospitals in 14 countries [5][3] - The main endpoint of the study combined three outcomes: death, another heart attack, or hospitalization for heart failure over three years, with no significant differences found between the two treatment strategies [5][3] - The results confirm that both immediate and staged treatment strategies are backed by solid evidence, allowing for more personalized care for patients [5][6] Group 2: Clinical Implications - The findings support current international guideline recommendations for complete revascularization in STEMI patients, integrating physiological assessment into treatment decisions [6][5] - The study provides cardiologists with the confidence to offer a complete solution in one session when appropriate, addressing a long-standing question in interventional cardiology [5][6] - Flexibility in treatment approaches is emphasized, as some patients may benefit from immediate treatment while others may be better served by waiting for further evaluation [6][5] Group 3: Related Studies - The ILIAS ANOCA study presented at the same conference demonstrated the value of physiology-guided decision-making in patients with angina and no obstructive coronary arteries, showing significant improvements in patient-reported symptoms [7][8] - The ILIAS ANOCA study involved 153 patients and confirmed the benefits of tailored therapy guided by coronary function testing [8][7] Group 4: Technology Utilization - Philips' iFR technology and advanced cardiac MRI were utilized in the iMODERN trial to guide treatment decisions, supporting the generation of robust evidence for clinical practice [9][10] - The integration of these technologies allows for both invasive and non-invasive approaches in evaluating treatment strategies for heart attack patients [9][10]