scholarly journals TCT-420: Very Long-term Clinical Follow-up After Fractional Flow Reserve-Guided Coronary Revascularization

2010 ◽  
Vol 56 (13) ◽  
pp. B96
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Revascularization ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals Long-Term Clinical Outcomes of Fractional Flow Reserve-Guided Coronary Artery Revascularization in Chronic Kidney Disease

2022 ◽  
Vol 12 (1) ◽  
pp. 21
Author(s):  
Chien-Boon Jong ◽  
Tsui-Shan Lu ◽  
Patrick Yan-Tyng Liu ◽  
Jeng-Wei Chen ◽  
Ching-Chang Huang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Fractional Flow Reserve ◽  
Primary Endpoint ◽  
Coronary Revascularization ◽  
Fractional Flow ◽  
Flow Reserve

Fractional flow reserve (FFR)-guided percutaneous coronary intervention has shown favorable long-term clinical outcomes. However, limited data exist evaluating the FFR assessment among the chronic kidney disease (CKD) population. The aim of this study was to evaluate the long-term clinical outcomes of FFR-guided coronary revascularization in patients with CKD. A total of 242 CKD patients who underwent FFR assessment were retrospectively analyzed. Patients were divided into two groups: revascularization (FFR ≤ 0.80) and non-revascularization (FFR > 0.80). The primary endpoint was the composite of cardiac death, non-fatal myocardial infarction, and target vessel failure (TVF). The key secondary endpoint was TVF. The Cox regression model was used for risk evaluation. With 91% of the ischemic vessels revascularized, the revascularization group had higher risks for both the primary endpoint (adjusted hazard ratio [aHR]: 2.06; 95% confidence interval [CI], 1.07–3.97; p = 0.030) and key secondary endpoint (aHR: 2.19, 95% CI: 1.10–4.37; p = 0.026), during a median follow-up of 2.9 years. This result was consistent among different CKD severities. In patients with CKD, functional ischemia in coronary artery stenosis was associated with poor clinical outcomes despite coronary revascularization.

Abstract 4470: Long Term Follow Up After Fractional Flow Reserve-guided Treatment Of ‘Moderate’ Left Main Coronary Artery Stenosis

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Michalis Hamilos ◽  
Thomas Cuisset ◽  
Jaydeep Sarma ◽  
Emanuele Barbato ◽  
Jozef Bartunek ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Left Main Coronary Artery ◽  
Medical Group ◽  
Left Main ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Surgical Group

Introduction: We assesed the value, in terms of long-term clinical outcome, of a fractional flow reserve (FFR)-guided treatment strategy in patients with angiographically ‘intermediate’ left main coronary artery (LMCA) stenoses. Methods: In 215 consecutive patients with an angiographically ‘intermediate’ unprotected LMCA stenosis (between 30–70%, by visual estimate), FFR measurements and off line quantitative coronary angiography (QCA) were obtained. When FFR was ≥0.80, patients were treated medically (medical group); When FFR was <0.80 coronary artery bypass grafting (CABG) was advocated (surgical group). Incidence of death, myocardial infarction and any coronary revascularisation procedure were recorded. Results: 140 patients had an FFR≥0.80 and 75 patients had an FFR<0.80. Percent diameter stenosis at QCA correlated significantly with FFR (r = −0.38, p<0.001), but a very large scatter was observed (Figure 1B ). Mean follow up duration was 35 ± 25 months. The incidence of death was 7.9 % in the medical group and 9.3 % in the surgical group. (Figure 1A , p=0.73). Conclusions : Angiography alone does not allow appropriate decision making in patients with angiographically ‘intermediate’ stenosis of the LMCA. Given the favorable outcome of an FFR-guided strategy such patients deserve FFR assessment before blindly proceeding to revascularisation. Figure 1: A Kaplan-Meier mortality curves for the 2 study groups. B Scatterplots showing the distribution of % diameter stenosis and the corresponding FFR values (filled dots indicate FFR≥0.80 and circles indicate FFR<0.80).

P6186Symptomatic effect of coronary revascularization at 1-year follow-up in stable chest pain - prediction by coronary computed tomography angiography derived fractional flow reserve

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K T Madsen ◽  
B L Noergaard ◽  
K T Veien ◽  
P Larsen ◽  
M Husain ◽  
...  
Keyword(s):  
Chest Pain ◽  
Fractional Flow Reserve ◽  
Coronary Revascularization ◽  
Symptomatic Relief ◽  
Fractional Flow ◽  
Coronary Cta ◽  
Coronary Ct ◽  
Flow Reserve ◽  
Stable Chest Pain

Abstract Introduction Coronary CT angiography (CTA) derived fractional flow reserve (FFRct) is increasingly being used for guiding referral to invasive procedures in patients with stable chest pain. However, the ability of FFRct to predict the symptomatic effect of revascularization remains unclear. Purpose To evaluate the ability of different vessel-specific physiological FFRct derived measures of ischemia for predicting the occurrence of chest pain one year after coronary revascularization in stable patients. Methods Retrospective study in patients with stable chest pain referred for coronary angiography based on coronary CTA. Standard acquired coronary CTA data sets were transmitted for core-laboratory analysis at HeartFlow. Patients were categorized as positive for ischemia using 3 different algorithms: Lowest in vessel FFRct-value ≤0.80; ΔFFRct ≥0.06 or a combination of the two. Personnel responsible for downstream patient management had no information on FFRct test results. Classification of revascularization was performed based on the applied FFRct algorithm: complete if all FFRct positive lesions were revascularized; incomplete if ≥1 FFRct positive lesion was not revascularized. Symptomatic status at 1-year follow-up was obtained by a visit in the outpatient clinic or by telephone. Results A total of 172 patients were included. Revascularization was performed in 62 (35%) patients. At 1-year follow-up 48 (28%) patients had chest pain; 15 (24%) revascularized vs 33 (30%) non-vascularized patients, p=0.415. No difference in utilization of anti-anginal medicine for patients with and without chest pain was registered at 1-year follow-up. The association between the chosen FFRct algorithm, revascularization and occurrence of chest pain at 1-year follow-up are shown in the Table. FFRct, Revascularization and Chest pain FFRCT, Algorithm Revascularizationb Patients with chest pain 1-year risk of chest pain p-valuec N (%) OR (95%-CI) Distal FFRCT ≤0.80 Incomplete 32 (34) Ref. Distal FFRCT ≤0.80 Complete 4 (15) 0.34 (0.11, 1.06) Distal FFRCT >0.80 No 11 (24) 0.61 (0.27, 1.35) 0.097 ΔFFRCT ≥0.06 Incomplete 34 (35) Ref. ΔFFRCT ≥0.06 Complete 7 (21) 0.49 (0.19, 1.24) ΔFFRCT <0.06 No 7 (18) 0.41 (0.16, 1.03) 0.074 Combinationa abnormal Incomplete 30 (40) Ref. Combination abnormal Complete 6 (18) 0.32 (0.12, 0.87) Combination normal No 11 (19) 0.35 (0.16, 0.78) 0.009 aDistal FFRCT ≤0.80 and ΔFFRCT ≥0.06. bIncomplete (≥1 FFRCT positive lesion not revascularized); complete (All FFRCT positive lesions revascularized); No (No FFRCT positive lesions and revascularization not performed). cBetween group comparison performed using logistic regression. Conclusion Revascularization based on classification by FFRct is associated with symptomatic relief at 1-year follow-up in patients with stable chest pain.

scholarly journals Long-term follow-up of patients with deferred coronary intervention guided by measurement of fractional flow reserve

2013 ◽  
Vol 32 (11) ◽  
pp. 885-891
Author(s):  
Luísa Vilalonga Pereira ◽  
Hélder Pereira ◽  
Hugo Vinhas ◽  
Cristina Martins ◽  
Rita Calé ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Long Term Follow Up

Abstract 3334: Comparison of Medical Treatment and Coronary Revascularization in Patients with Moderate Coronary Lesions and Borderline Fractional Flow Reserve Measurements

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Javier Courtis ◽  
Olivier F Bertrand ◽  
Eric Larose ◽  
Can M Nguyen ◽  
Jean-Pierre Déry ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Medical Treatment ◽  
Fractional Flow Reserve ◽  
Coronary Revascularization ◽  
Previous Myocardial Infarction ◽  
Cardiac Events ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Coronary Lesions

Background. There is little information available regarding deferral of revascularization in cases of fractional flow reserve (FFR) measurements in the borderline range (between 0.75 to 0.80). The objectives of this study were to evaluate the clinical outcomes of patients with moderate coronary lesions and FFR measurements between 0.75 and 0.80, comparing those who underwent coronary revascularization (CR) to those who had medical treatment (MT), and to determine the predictive factors of major adverse cardiac events (MACE) at follow-up. Methods. A total of 107 consecutive patients (mean age 62 ± 10 years) with at least one moderate coronary lesion (mean percent diameter stenosis 47 ± 12%) evaluated by coronary pressure wire with FFR measurement between 0.75 and 0.80 (mean 0.77 ± 0.02) were included in the study. Maximal hyperemia was obtained by intracoronary administration of adenosine (mean dose 215 ± 84 μg). MACE (coronary revascularization, myocardial infarction, cardiac death) and the presence of angina were evaluated at follow-up. Results. A total of 63 patients (59%) underwent CR and 44 patients (41%) had MT, with no clinical differences between groups. At a mean follow-up of 13 ± 7 months, MACE related to the coronary lesion evaluated by FFR were higher in the MT group compared to CR group (23% vs 5%, difference 18%, 95% CI 5%–30%, p=0.005). FFR measurement in an artery supplying a territory with previous myocardial infarction was the only predictive factor of MACE in the MT group (odds ratio 14.1, 95% CI 1.3–39, p=0.03). The presence of angina at follow-up was more frequent in the MT group compared to the CR group (41% vs 9%, difference 32%, 95% CI 11%–49%, p<0.001). Conclusions. In patients with moderate coronary lesions and FFR measurements in the “grey zone” range deferral of revascularization was associated with a higher rate of cardiac events and a higher prevalence of angina at follow-up, especially in those with previous myocardial infarction in the territory evaluated by FFR. These results suggest that a FFR cut-off point of 0.80 rather than 0.75 might be more appropriate for deferring coronary revascularization in these cases.

P3652Hemodynamic and clinical impact of ANOmalous connections of CORonary arteries using computed tomography-derived Fractional Flow Reserve (FFRCT) from the ANOCOR registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Adjedj ◽  
F H Hyafil ◽  
W F Ferrag ◽  
R F Farnoud ◽  
O M Muller ◽  
...  
Keyword(s):  
Computed Tomography ◽  
At Risk ◽  
Coronary Arteries ◽  
Fractional Flow Reserve ◽  
Coronary Revascularization ◽  
Clinical Impact ◽  
Functional Evaluation ◽  
Fractional Flow ◽  
Flow Reserve

Abstract Background With the emergence of coronary computed tomography angiography (CCTA), ANOmalous connections of CORonary arteries (ANOCOR) are more frequently diagnosed than previously reported. CT-derived Fractional Flow Reserve (FFRCT) is a non-invasive functional test providing anatomical and functional evaluation of the overall coronary tree. These unique features could help for the management of patients with ANOCOR. Objective We aimed to retrospectively evaluate the clinical impact of FFRCT analysis in the ANOCOR registry population with 3 year-follow-up. Method The ANOCOR registry included adult patients with ANOCOR detected during invasive coronary angiogram or CCTA performed between January 2010 and January 2013. Among 472 patients included, 105 patients had a cardiac CT during the inclusion period. Results We retrospectively performed FFR-CT and obtained successful analyses in 54 patients of 60±13 years with a complete 3-year clinical follow-up. Thirty-six (67%) patients had conservative treatment and 18 (33%) patients had coronary revascularization after the CCTA. FFRCT analysis showed that ANOCOR course slightly reduces the mean FFRCT value of 1 at the ostium to 0.90±0.10 downstream the abnormal course and had a distal vessel mean FFRCT value 0.82±0.11. No statistical difference of FFRCT values were observed between ANOCOR at risk and non at risk and between conservative and revascularization groups. At 3 years of follow-up, only one patient had unplanned revascularizations of ANOCOR vessel in the conservative strategy group. Conclusion We observed favorable FFRCT values of ANOCOR and non ANOCR vessels. Patients treated conservatively and revascularized had excellent clinical outcome at 3 years of follow up.

Sign in / Sign up

Export Citation Format

Share Document