Document Detail


The prognostic value of combined fractional flow reserve and TIMI frame count measurements in patients with stable angina pectoris and acute coronary syndrome.
MedLine Citation:
PMID:  20624205     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to evaluate the prognostic value of different fractional flow reserve (FFR) cutoff values and corrected thrombolysis in myocardial infarction frame (TIMI) count (CTFC) measurements in a series of consecutive patients with moderate coronary lesions, including patients with unstable angina, myocardial infarction, and/or positive noninvasive functional test findings.
METHODS: We included 162 consecutive coronary patients in whom revascularization of a moderate coronary lesion was deferred based on a FFR value ≥0.75. Patients were divided according to the results of the intracoronary pressure and flow measurements into four groups: group A: 0.75 ≤ FFR ≤ 0.85 and CTFC > 28 (n=22), group B: 0.75 ≤ FFR ≤ 0.85 and CTFC ≤ 28 (n = 55), group C: 0.85 < FFR and CTFC > 28 (n = 19), and group D: 0.85 < FFR and CTFC ≤ 28 (n = 66). Adverse cardiac events and the presence of angina were evaluated at follow-up.
RESULTS: At a mean follow-up of 18 ± 10 months, cardiac event rate in patients with 0.75 ≤ FFR ≤ 0.85 and FFR > 0.85 were 22% and 9%, respectively (P = 0.026) and also, a trend was observed toward a higher cardiac event rate in case of an abnormal CTFC (CTFC > 28) compared to a normal CTFC (24% vs 12%, P = 0.066). Furthermore, a significantly higher cardiac event rate was observed when group A was compared to group D (31.8% vs 7.6%, respectively, P = 0.004).
CONCLUSION: Patients with potential microvascular dysfunction and borderline FFR values should be interpreted with caution, and management strategies should be guided not only by pressure measurement, but also by possibly supplementary clinical risk stratification and noninvasive tests.
Authors:
Ali M Esen; Goksel Acar; Ozlem Esen; Yunus Emiroglu; Mustafa Akcakoyun; Selcuk Pala; Hekim Karapinar; Ramazan Kargin; Irfan Barutcu; Muhsin Turkmen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  23     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  421-8     Citation Subset:  IM    
Copyright Information:
©2010, Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Heart-Education and Research Hospital, Istanbul, Turkey.
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