Document Detail


Long-term clinical outcome after fractional flow reserve-guided percutaneous coronary intervention in patients with multivessel disease.
MedLine Citation:
PMID:  16053955     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: In the present study, we analyzed the clinical outcome of patients with multivessel coronary artery disease in whom at least one vessel was treated by percutaneous coronary intervention (PCI) and at least one other vessel was deferred on the basis of fractional flow reserve (FFR) measurements during the same session. BACKGROUND: Myocardial FFR is an established tool for assessing the severity of epicardial stenoses. It has been shown that it is safe to defer an intervention in single vessel disease patients when FFR >0.75. METHODS: One hundred two patients (66 +/- 10 years) with multivessel coronary artery disease were included in the study. In all patients, PCI of at least two vessels was contemplated. Yet in all of them at least one vessel was treated by PCI, whereas at least one other vessel was deferred based on an FFR >0.75. Major adverse cardiac events (MACE) were recorded during an average follow-up of 29 +/- 18 months. RESULTS: In 102 patients, 113 coronary arteries underwent PCI. In these arteries FFR was 0.57 +/- 0.13 and mean diameter stenosis was 68 +/- 14%. One hundred twenty-seven coronary arteries had an FFR >0.75 and PCI was deferred. In these arteries FFR was 0.86 +/- 0.06 and mean diameter stenosis was 47 +/- 12%. No death occurred during the follow-up. A MACE occurred in 9% and 13% of patients after 12 and 36 months, respectively. These MACE were related to 22 (9.2%) arteries. Among them, 8 (6.3%) MACE were related to one of the initially deferred vessels, whereas 14 (12.3%) MACE were related to one of the initially treated coronary artery. CONCLUSIONS: In patients with multivessel disease, PCI of hemodynamically non-significant stenoses can be safely deferred, even if initially planned on the basis of the angiogram.
Authors:
Alexandre Berger; Kees-Joost Botman; Philip A MacCarthy; William Wijns; Jozef Bartunek; Guy R Heyndrickx; Nico H J Pijls; Bernard De Bruyne
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  46     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-01     Completed Date:  2005-08-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  438-42     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods*,  mortality
Chi-Square Distribution
Cohort Studies
Coronary Angiography / methods
Coronary Circulation / physiology*
Coronary Stenosis / mortality,  radiography*,  therapy*
Coronary Vessels / pathology
Female
Follow-Up Studies
Heart Function Tests
Hemodynamics / physiology
Humans
Male
Middle Aged
Myocardial Infarction / mortality,  radiography,  therapy
Probability
Recovery of Function
Retrospective Studies
Risk Assessment
Severity of Illness Index
Survival Rate
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
//Wellcome Trust

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