Treatment of Functionally Non-significant Vulnerable Plaques in Patients With Multivessel ST-elevation Myocardial Infarction The VULNERABLE Trial

Inclusion Criteria:

• Patients > 18 years.

• Successful revascularization of the culprit lesion in patients undergoing coronaryangiography due to ST-segment elevation (> 1mm in > 2 contiguous leads, new leftbundle branch block, or true posterior MI with ST depression of >1mm in >2contiguous anterior leads) in the first 72 hours of the symptom's onset.

• Multivessel coronary disease with non-culprit lesions located in different vesselsthan the culprit lesion and ranging from 40 to 69% of DS (visual estimated diameterstenosis ) by visual estimate planned for FFR-guided revascularization in stagedprocedure (>24 hours and <60 days after PCI of the culprit lesion).

• Non-culprit lesions should be suitable for functional assessment with pressure wireand OCT catheter and should be suitable to be treated with a single 2.0 to 4.5 mmEES (everolimus-eluting stent ).

• Subject agrees to not participate in any other clinical trial study for a period of 4 years following the inclusion in the study.

• Informed consent signed.

Exclusion Criteria:

• Inability to provide informed consent.

• Female of childbearing potential (age <50 years and last menstruation within thelast 12 months), who did not undergo tubal ligation, ovariectomy or hysterectomy.

• Known intolerance to aspirin, heparin, everolimus, contrast material.

• Unresolved mechanical complication or cardiogenic shock at the staged procedure.

• Non-culprit study lesions located in the left main coronary artery or in coronaryvessels with prior coronary revascularization (PCI or by-pass) or with distal vesselocclusion.

• Patients with long, bifurcated, severely angulated or severely calcified non-culpritstudy lesions non suitable to be treated with a single EES implantation.

• Asthma or known history of bronchial hyper-reactivity.

• Chronic renal dysfunction with creatinine clearance < 45 ml/min.

• Severe comorbidities that in the opinion of the local investigators determine thepatient's life expectancy < 4 years.

• Subject is currently participating in another clinical trial that has not yetcompleted its primary endpoint.