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Long-Term Clinical Outcomes of Fractional Flow Reserve-Guided Versus Routine Drug-Eluting Stent Implantation in Patients With Intermediate Coronary Stenosis: Five-Year Clinical Outcomes of DEFER-DES Trial.

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Author(s)
Sang Hyun ParkKi-Hyun JeonJoo Myung LeeChang-Wook NamJoon-Hyung DohBong-Ki LeeSeung-Woon RhaKi-dong YooKyung Tae JungYoung-Seok ChoHae-Young LeeTae-Jin YounWoo-Young ChungBon-Kwon Koo
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Circulation: Cardiovascular Interventions.
Issued Date
2015
Volume
8
Issue
12
Keyword
Coronary artery diseaseCoronary stenosisDrug-eluting stentsMyocardial fractional flow reservePercutaneous coronary intervention
Abstract
Background—We aimed to compare the long-term clinical outcomes between fractional flow reserve (FFR)–guided and
routine drug-eluting stent (DES) implantation in patients with an intermediate coronary stenosis.
Methods and Results—A total of 229 patients with an angiographically intermediate coronary stenosis were randomly
assigned to FFR-guided or Routine-DES implantation group. For FFR-guided group (n=114), treatment strategy was
determined according to the target vessel FFR (FFR<0.75: DES implantation [FFR-DES group]; FFR≥0.75: deferral
of stenting [FFR-Defer group]). Routine-DES group underwent DES implantation without FFR measurement (n=115).
The primary end point was the incidence of major adverse cardiac events, a composite of cardiac death, myocardial
infarction, and target lesion revascularization. Of lesions assigned to FFR-guided strategy, only one quarter had functional
significance (FFR<0.75). At 2-year follow-up, the cumulative incidence of major adverse cardiac events was 7.9±2.5%
in the FFR-guided group and 8.8±2.7% in Routine-DES group (P=0.80). At 5-year follow-up, the cumulative incidence
of major adverse cardiac events was 11.6±3.0% and 14.2±3.3% for the FFR-guided group and the Routine-DES group
(P=0.55). There was no difference in major adverse cardiac events rates between the 2 groups ≤5-year follow-up (hazard
ratio, 1.25; 95% confidence interval, 0.60–2.60).
Conclusions—In lesions with angiographically intermediate stenosis, FFR guidance provides a tailored approach, which is
at least as good as an angiography-guided routine-DES implantation strategy and avoids unnecessary DES-stenting in a
considerable part of the patients.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine
Citation
Sang Hyun Park et al. (2015). Long-Term Clinical Outcomes of Fractional Flow Reserve-Guided Versus Routine Drug-Eluting Stent Implantation in Patients With Intermediate Coronary Stenosis: Five-Year Clinical Outcomes of DEFER-DES Trial. Circulation: Cardiovascular Interventions., 8(12), e002442–e002442. doi: 10.1161/CIRCINTERVENTIONS.115.002442
Type
Article
ISSN
1941-7640
DOI
10.1161/CIRCINTERVENTIONS.115.002442
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32989
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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