# Thomas Engstrøm
Thomas Engstrøm is a Danish interventional cardiologist.[1](https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/) He is known for founding and leading the [DANAMI-3 trial](https://www.edgepedia.org/danami-3-trial) program in ST-segment elevation myocardial infarction (STEMI), which tested deferred stent implantation, [ischemic postconditioning](https://www.edgepedia.org/ischemic-postconditioning), and complete versus culprit-lesion-only revascularisation, and for the 2025 individual-patient-data meta-analysis of complete revascularisation by the Complete Revascularisation Trialists' Collaboration in [The Lancet](https://www.edgepedia.org/the-lancet).[1](https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/) • [2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02170-1/abstract) His main research areas are myocardial protection in ischemic heart disease with reference to reperfusion injury, percutaneous assist devices in cardiogenic shock, and pressure-derived strategies in percutaneous coronary intervention (PCI).[1](https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/)
| Fact | Detail |
|---|---|
| Position | Clinical Professor and senior consultant, The Heart Centre, Rigshospitalet, University of Copenhagen[1](https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/) |
| Department leadership | Head of Department of Invasive Cardiology, Rigshospitalet, 2007–2016[1](https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/) |
| Signature work | DANAMI-3 program: three randomised trials in STEMI patients (iPOST, DEFER, PRIMULTI)[3](https://www.sciencedirect.com/science/article/abs/pii/S0002870315001027) |
| DANAMI 3-DEFER result | Deferred stenting did not reduce the primary composite endpoint: 18% vs 17% (HR 0.99; p=0.92)[4](https://research.regionh.dk/en/publications/deferred-versus-conventional-stent-implantation-in-patients-with-/) |
| DANAMI-3, PRIMULTI result | Complete revascularisation reduced the primary endpoint: 13% vs 22% (HR 0.56; p=0.004)[5](https://europepmc.org/article/MED/26347918) |
| 2025 meta-analysis | Six trials, 8,836 patients: cardiovascular death or new MI 9.0% vs 11.5% (HR 0.76; p<0.0001)[2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02170-1/abstract) |
| Industry roles | Advisory boards for Novo Nordisk and Abbott Medical; speakers' fees from Abbott Medical, Boston Scientific, and Novo Nordisk[1](https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/) |
## Career and appointments
Engstrøm was Head of Department of Invasive Cardiology at The Heart Center, Rigshospitalet from 2007 to 2016.[1](https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/) He now holds a dual appointment as clinical professor in the Department of Clinical Medicine, employed by both the Capital Region of Denmark and the [University of Copenhagen](https://www.edgepedia.org/university-of-copenhagen).[6](https://researchprofiles.ku.dk/en/persons/thomas-engstr%C3%B8m/) He is also professor in cardiology at the University of Lund, Sweden, and adjunct professor in cardiology at the University of Aalborg, Denmark.[7](https://medicalresearch.com/ischemic-postconditioning-during-primary-pci-for-patients-with-stemi-heart-attack/dr-thomas-engstrom/) His degrees are listed as MD, PhD, and dr.scient. (DMSci).[7](https://medicalresearch.com/ischemic-postconditioning-during-primary-pci-for-patients-with-stemi-heart-attack/dr-thomas-engstrom/) At Rigshospitalet he has performed percutaneous coronary interventions for more than 15 years, and he has led steering committees in several international clinical trials.[8](https://esc365.escardio.org/person/33890)
## Representative work
The DANAMI-3 program, of which Engstrøm is founder and principal investigator, comprised three randomised multicentre trials nested in a single Danish setup, enrolling about 1,800 STEMI patients undergoing primary PCI: iPOST (ischemic postconditioning), DEFER (deferred stent implantation), and PRIMULTI (FFR-guided complete revascularisation versus culprit-lesion-only treatment).[1](https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/) • [3](https://www.sciencedirect.com/science/article/abs/pii/S0002870315001027) In the DEFER arm, stenting was postponed for 48 hours after the infarct artery had been re-opened.[9](https://clinicaltrials.gov/study/NCT01435408)
The DEFER trial was negative: 1,215 patients at four Danish primary PCI centers were randomised between March 2011 and February 2014, and the primary composite endpoint occurred in 109 of 612 standard-PCI patients (18%) versus 105 of 603 deferred-stent patients (17%) over a median 42-month follow-up (hazard ratio 0.99, 95% CI 0.76–1.29; p=0.92). Routine deferred stent implantation did not reduce death, heart failure, myocardial infarction, or repeat revascularisation.[4](https://research.regionh.dk/en/publications/deferred-versus-conventional-stent-implantation-in-patients-with-/)
According to Engstrøm's University of Copenhagen research profile, the [PRIMULTI trial](https://www.edgepedia.org/primulti-trial), published in The Lancet in 2015 with Engstrøm as first author, was positive. It enrolled 627 STEMI patients with multivessel disease at two Danish university hospitals; 313 received culprit-lesion-only PCI and 314 received complete revascularisation guided by fractional flow reserve (FFR). The primary composite endpoint occurred in 68 of 313 culprit-only patients (22%) versus 40 of 314 complete-revascularisation patients (13%) at a median 27-month follow-up (HR 0.56, 95% CI 0.38–0.83; p=0.004). The effect was driven by fewer repeat revascularisations; all-cause mortality and non-fatal reinfarction did not differ between groups.[5](https://europepmc.org/article/MED/26347918)
He also led the VERDICT trial, which tested a very early (under 12 hours) invasive evaluation strategy using computerized tomography in acute coronary syndromes.[10](https://www.crtonline.org/Assets/dbee484c-7426-47ff-9a01-df32405c9ff9/636753626301470000/verdict-engstrom-pdf)
## Complete versus culprit-lesion-only revascularisation: how the evidence compares
The question matters because roughly 40–60% of patients with STEMI have multivessel disease, which is associated with worse outcomes than single-vessel disease.[11](https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-019-1073-8) The DANAMI-3, PRIMULTI result was followed by the COMPLETE trial, in which more than 3,000 patients with STEMI and multivessel disease were randomized; at a median 3 years, cardiovascular death or myocardial infarction occurred in 7.8% with complete revascularization versus 10.5% with culprit-lesion-only PCI (HR 0.74; P=0.004), and the broader composite outcome in 8.9% versus 16.7% (HR 0.51; P<0.001).[12](https://www.nejm.org/doi/full/10.1056/NEJMoa1907775)
Not every trial agrees. The FULL REVASC trial randomised 1,542 patients with STEMI or very-high-risk NSTEMI and multivessel disease and found that FFR-guided complete revascularisation was not shown to result in a lower risk of death, myocardial infarction, or unplanned revascularisation than culprit-lesion-only PCI at 4.8 years.[13](https://www.nejm.org/doi/full/10.1056/NEJMoa2314149) Timing trials have been more consistent: MULTISTARS AMI found immediate multivessel PCI noninferior to staged PCI 19–45 days later in hemodynamically stable STEMI patients,[14](https://www.ovid.com/journals/nejm/pdf/10.1056/nejmoa2307823~timing-of-complete-revascularization-with-multivessel-pci) while OPTION–STEMI randomised 994 patients and found immediate revascularisation not non-inferior to staged revascularisation during the index admission (13% vs 11% at 1 year; HR 1.24).[15](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2825%2901529-6/abstract?rss=yes)
In 2025 Engstrøm led the Complete Revascularisation Trialists' Collaboration, an individual-patient-data meta-analysis pooling six randomised trials with 8,836 patients, of whom 7,768 (87.9%) presented with STEMI. At a median follow-up of 36.0 months, cardiovascular death or new myocardial infarction occurred in 382 of 4,259 complete-revascularisation patients (9.0%) versus 528 of 4,577 culprit-lesion-only patients (11.5%) (HR 0.76, 95% CI 0.67–0.87; p<0.0001); cardiovascular death was 3.6% versus 4.6% and all-cause death 7.2% versus 8.1% (HR 0.85; p=0.039). The collaboration states these data provide the strongest and most robust evidence to date that complete revascularisation improves important cardiovascular clinical outcomes.[2](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02170-1/abstract)
## Recent developments
Ten-year follow-ups of both DANAMI-3 trials appeared in 2025. The 10-year DANAMI-3-DEFER follow-up, published in Circulation: Cardiovascular Interventions, tracked hospitalization for heart failure, or all-cause mortality in about 1,000 of the original patients.[16](https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.125.015369) The 10-year PRIMULTI follow-up, published in the [Journal of the American College of Cardiology](https://www.edgepedia.org/journal-of-the-american-college-of-cardiology), found that complete revascularization still reduced the risk of the primary composite outcome (hazard ratio of about 0.6). Deaths were 78 of 313 (25%) in the infarct-artery-only group versus 74 of 314 (24%) with complete revascularisation; complete revascularisation reduced any revascularisation (OR 0.62) but showed no difference in recurrent myocardial infarction (OR 0.90).[17](https://vbn.elsevierpure.com/da/publications/10-year-outcome-of-complete-or-infarct-artery-only-revascularizat/) Presenting these data at EuroPCR 2025, Engstrøm stated that complete revascularisation may provide an absolute reduction of about 10 events per 100 patients over ten years; according to Radcliffe Cardiology's coverage, he noted that the COMPLETE trial showed the same direction of benefit, said the practice is now in guidelines, and named imaging-based identification of non-ischemic but vulnerable lesions as the next research step.[18](https://www.radcliffecardiology.com/video-index/europcr-25-danami-3-primulti-trial-complete-or-culprit-only-revascularisation-stemi?language_content_entity=en)
The field has since moved to how complete revascularisation should be guided. The AIR-STEMI trial, presented at ESC 2026, found at a median 17.9-month follow-up that the primary endpoint occurred in 8.9% of physiology-guided versus 13.7% of angiography-guided complete revascularisation in STEMI with multivessel disease (HR 0.62, 95% CI 0.47–0.83; p<0.001; number needed to treat 21), remaining significant when type 4a myocardial infarction was excluded (HR 0.67).[19](https://www.pcronline.com/News/Congress-coverages/ESC/2026/AIR-STEMI-functional-coronary-angiography-in-STEMI)
## References
1. Thomas Engstrøm – Region Hovedstadens forskningsportal. https://research.regionh.dk/en/persons/thomas-engstr%C3%B8m/
2. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02170-1/abstract
3. Rationale and design of the DANAMI 3 trial program, American Heart Journal. https://www.sciencedirect.com/science/article/abs/pii/S0002870315001027
4. Deferred versus conventional stent implantation in patients with STEMI (DANAMI 3-DEFER), The Lancet 2016. https://research.regionh.dk/en/publications/deferred-versus-conventional-stent-implantation-in-patients-with-/
5. DANAMI-3, PRIMULTI, The Lancet 2015 (Europe PMC record). https://europepmc.org/article/MED/26347918
6. Thomas Engstrøm – University of Copenhagen Research. https://researchprofiles.ku.dk/en/persons/thomas-engstr%C3%B8m/
7. Dr. Thomas Engstrøm – MedicalResearch.com interview. https://medicalresearch.com/ischemic-postconditioning-during-primary-pci-for-patients-with-stemi-heart-attack/dr-thomas-engstrom/
8. Professor Thomas Engstrom – ESC 365. https://esc365.escardio.org/person/33890
9. DANAMI-3, NCT01435408, ClinicalTrials.gov. https://clinicaltrials.gov/study/NCT01435408
10. VERDICT trial presentation, Thomas Engstrøm (CRT). https://www.crtonline.org/Assets/dbee484c-7426-47ff-9a01-df32405c9ff9/636753626301470000/verdict-engstrom-pdf
11. Complete versus culprit-only revascularization in STEMI and multivessel disease: a meta-analysis, BMC Cardiovascular Disorders 2019. https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-019-1073-8
12. Complete Revascularization with Multivessel PCI for Myocardial Infarction (COMPLETE), NEJM 2019. https://www.nejm.org/doi/full/10.1056/NEJMoa1907775
13. FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction (FULL REVASC), NEJM. https://www.nejm.org/doi/full/10.1056/NEJMoa2314149
14. Timing of Complete Revascularization with Multivessel PCI in Myocardial Infarction (MULTISTARS AMI), NEJM 2023. https://www.ovid.com/journals/nejm/pdf/10.1056/nejmoa2307823~timing-of-complete-revascularization-with-multivessel-pci
15. Immediate versus staged complete revascularisation during index admission in STEMI (OPTION–STEMI), The Lancet 2025. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2825%2901529-6/abstract?rss=yes
16. 10-Year Outcomes of Deferred or Conventional Stent Implantation in Patients With STEMI (DANAMI-3-DEFER), Circulation: Cardiovascular Interventions 2025. https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.125.015369
17. 10-Year Outcome of Complete or Infarct Artery-Only Revascularization in STEMI With Multivessel Disease (DANAMI-3-PRIMULTI), JACC 2025. https://vbn.elsevierpure.com/da/publications/10-year-outcome-of-complete-or-infarct-artery-only-revascularizat/
18. EuroPCR 25: The DANAMI-3-PRIMULTI Trial, Radcliffe Cardiology. https://www.radcliffecardiology.com/video-index/europcr-25-danami-3-primulti-trial-complete-or-culprit-only-revascularisation-stemi?language_content_entity=en
19. AIR-STEMI trial: complete revascularisation guided by functional coronary angiography in STEMI, ESC 2026. https://www.pcronline.com/News/Congress-coverages/ESC/2026/AIR-STEMI-functional-coronary-angiography-in-STEMI
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*Topic: Encyclopedia › Life and health › Life and health scientists › Medical and health researchers › Researchers in cardiovascular, metabolic, and endocrine research › Interventional cardiology researchers*
*Initially written Sep 21, 2026 · Reviewed: Sep 25, 2026; Sep 30, 2026 · Edited: Sep 25, 2026; Oct 11, 2026; Oct 15, 2026; Oct 21, 2026 · Last review: Sep 30, 2026*
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