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.

scholarly journals Safety of coronary revascularization deferral based on fractional flow reserve and instantaneous wave-free ratio in patients with chronic kidney disease

2021 ◽  
Author(s):  
Alejandro Travieso ◽  
Alex Fernando Castro-Mejia ◽  
Adrian Jeronimo-Baza ◽  
Maria Jose Perez-Vizcayno ◽  
Hernan Mejia-Renteria ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fractional Flow Reserve ◽  
Coronary Revascularization ◽  
Fractional Flow ◽  
Flow Reserve

Fractional flow reserve in patients with chronic kidney disease and severe arterial hypertension: one size does not fit all

2020 ◽  
Vol 68 (3) ◽  
Author(s):  
Armando Del Prete ◽  
Domenico G. Della Rocca ◽  
Simone Calcagno ◽  
Riccardo Di Pietro ◽  
Antonio Di Matteo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Hypertension ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals TCT-629 Long-term clinical outcomes after real world use of fractional flow reserve

2013 ◽  
Vol 62 (18) ◽  
pp. B191
Author(s):  
Sang Hyun Park ◽  
Bon-Kwon Koo ◽  
Joon-Hyung Doh ◽  
Chang-Wook Nam ◽  
Ju-Hee Lee ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Fractional Flow Reserve ◽  
Real World ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals Impact of subclinical coronary artery disease on the clinical outcomes of carotid endarterectomy

2017 ◽  
Vol 126 (5) ◽  
pp. 1560-1565 ◽  
Author(s):  
Hyunwook Kwon ◽  
Dae Hyuk Moon ◽  
Youngjin Han ◽  
Jong-Young Lee ◽  
Sun U Kwon ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Primary Endpoint ◽  
Coronary Revascularization ◽  
Perioperative Period ◽  
Long Term Outcomes ◽  
Cardiac Damage ◽  
Artery Disease

OBJECTIVEControversy persists regarding the optimal management of subclinical coronary artery disease (CAD) prior to carotid endarterectomy (CEA) and the impact of CAD on clinical outcomes after CEA. This study aimed to evaluate the short-term surgical risks and long-term outcomes of patients with subclinical CAD who underwent CEA.METHODSThe authors performed a retrospective study of data from a prospective CEA registry. They analyzed a total of 702 cases involving patients without a history of CAD who received preoperative cardiac risk assessment by radionuclide myocardial perfusion imaging (MPI) and underwent CEA over a 10-year period. The management strategy (the necessity, sequence, and treatment modality of coronary revascularization and optimal perioperative medical treatment) was determined according to the presence, severity, and extent of CAD as determined by preoperative MPI and additional coronary computed tomography angiography and/or coronary angiography. Perioperative cardiac damage was defined on the basis of postoperative elevation of the blood level of cardiac troponin I (0.05–0.5 ng/ml) in the absence of myocardial ischemia. The primary endpoint was the composite of any stroke, myocardial infarction, or death during the perioperative period and all-cause mortality within 4 years of CEA. The associations between clinical outcomes after CEA and subclinical CAD were analyzed.RESULTSConcomitant subclinical CAD was observed in 81 patients (11.5%). These patients did have a higher incidence of perioperative cardiac damage (13.6% vs 0.5%, p < 0.01), but they had similar primary endpoint incidences during the perioperative period (2.5% vs.1.8%, p = 0.65) and similar estimated 4-year primary endpoint rates (13.6% vs 12.4%, p = 0.76) as the patients without subclinical CAD. Kaplan-Meier survival analysis showed that the 2 groups had similar rates of overall survival (p = 0.75).CONCLUSIONSPatients with subclinical CAD can undergo CEA with acceptable short- and long-term outcomes provided they receive selective coronary revascularization and optimal perioperative medical treatment.

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