계명대학교 의학도서관 Repository

Fractional Flow Reserve and Cardiac Events in Coronary Artery Disease Data From a Prospective IRIS-FFR Registry

Metadata Downloads
Author(s)
Young-Hak KimJung-Min AhnDuk-Woo ParkEun-Seok ShinBon-Kwon KooChang-Wook NamJoon-Hyung DohJune Hong KimIn-Ho ChaeJung-Han YoonSung-Ho HerKi-Bae SeungWoo-Young ChungSang-Yong YooJin Bae LeeSi Wan ChoiKyungil ParkTaek Jong HongSang Yeub LeeMinkyu HanPil Hyung LeeSoo-Jin KangSeung-Whan LeeCheol Whan LeeSeong-Wook ParkSeung-Jung Park
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Circulation
Issued Date
2017
Volume
135
Issue
23
Keyword
coronary diseasecoronary stentfractional flow reserverevascularization
Abstract
Background—We evaluated the prognosis of deferred and revascularized coronary stenoses after FFR measurement to assess its revascularization threshold in clinical practice.

Methods—The IRIS-FFR registry prospectively enrolled 5846 patients with at least one coronary lesion with FFR measurement. Revascularization was deferred in 6468 lesions and performed in 2165 lesions after FFR assessment. The primary endpoint was major adverse cardiac events (MACE; cardiac death, myocardial infarction, and repeat revascularization) at a median follow-up of 1.9 years and analyzed on a per-lesion basis. A marginal Cox model accounted for correlated data in patients with multiple lesions, and a model to predict per-lesion outcomes was adjusted for confounding factors.

Results—For deferred lesions, the risk of MACE demonstrated a significant, inverse relationship with FFR (adjusted hazard ratio [aHR], 1.06; 95% confidence interval [CI], 1.05-1.08; P < 0.001). However, this relationship was not observed in revascularized lesions (aHR, 1.00; 95% CI, 0.98-1.02; P = 0.70). For lesions with FFR ≥ 0.76, the risk of MACE was not significantly different between deferred and revascularized lesions. Conversely, in lesions with FFR ≤ 0.75, the risk of MACE was significantly lower in revascularized lesions than in deferred lesions (for FFR 0.71-0.75, aHR, 0.47; 95% CI, 0.24-0.89; P = 0.021, and for FFR ≤ 0.70, aHR 0.47; 95% CI, 0.26-0.84; P = 0.012).

Conclusions—This large, prospective registry showed that the FFR value was linearly associated with the risk of cardiac events in deferred lesions. In addition, revascularization for coronary artery stenosis with a low FFR (≤ 0.75) was associated with better outcomes than the deferral, while for a stenosis with a high FFR (≥ 0.76), medical treatment would be a reasonable and safe treatment strategy.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine
Citation
Young-Hak Kim et al. (2017). Fractional Flow Reserve and Cardiac Events in Coronary Artery Disease Data From a Prospective IRIS-FFR Registry. Circulation, 135(23), 2241–2241. doi: 10.1161/CIRCULATIONAHA.116.024433
Type
Article
ISSN
0009-7322
Source
http://circ.ahajournals.org/content/135/23/2241
DOI
10.1161/CIRCULATIONAHA.116.024433
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32736
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
공개 및 라이선스
  • 공개 구분공개
  • 엠바고Forever
파일 목록

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.