A Diagnostic Paradigm Shift in Acute Myocardial Infarction: Rationale and Design of the DIFOCCULT-3 Trial.

ABSTRACT:

Background

The current ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) paradigm have long been the cornerstone of myocardial infarction (MI) care but fail to identify many patients with acute coronary occlusion (ACO), delaying treatment and worsening outcomes.

Objectives

The new occlusive MI (OMI) and nonocclusive MI (NOMI) paradigm addresses these limitations by shifting from rigid electrocardiography (ECG)-driven thresholds to a pathophysiology-based strategy. It integrates clinical judgment, ECG subtleties, supportive artificial intelligence, biomarkers, and imaging when needed to actively detect ACO. The current trial investigates whether this approach improves outcomes.

Methods

The DIFOCCULT-3 (Time f

SUBMITTER: Aslanger EK 

PROVIDER: S-EPMC12717606 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature