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Outcomes of Percutaneous Coronary Intervention in Intermediate Coronary Artery Disease Fractional Flow Reserve–Guided Versus Intravascular Ultrasound–Guided

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Author(s)
Chang-Wook NamHyuck-Jun YoonYun-Kyeong ChoHyoung-Seob ParkHyungseop KimSeung-Ho HurYoon-Nyun KimIn-Sung ChungBon-Kwon KooSeung-Jae TahkWilliam F. FearonKwon-Bae Kim
Keimyung Author(s)
Nam, Chang WookYoon, Hyuck JunCho, Yun KyeongPark, Hyoung SeobKim, Hyung SeopHur, Seung HoKim, Yoon NyunKim, Kwon BaeChung, In Sung
Department
Dept. of Internal Medicine (내과학)
Dept. of Preventive Medicine (예방의학)
Journal Title
JACC: Cardiovascular Interventions
Issued Date
2010
Volume
3
Issue
8
Keyword
coronary angiographyfractional flow reserveintravascular ultrasoundoutcomepercutaneous coronary intervention
Abstract
Objectives:

This study sought to evaluate the long-term clinical outcomes of a fractional flow reserve (FFR)–guided percutaneous coronary intervention (PCI) strategy compared with intravascular ultrasound (IVUS)–guided PCI for intermediate coronary lesions.


Background:

Both FFR- and IVUS-guided PCI strategies have been reported to be safe and effective in intermediate coronary lesions.


Methods:

The study included 167 consecutive patients, with intermediate coronary lesions evaluated by FFR or IVUS (FFR-guided, 83 lesions vs. IVUS-guided, 94 lesions). Cutoff value of FFR in FFR-guided PCI was 0.80, whereas that for minimal lumen cross sectional area in IVUS-guided PCI was 4.0 mm2. The primary outcome was defined as a composite of major adverse cardiac events including death, myocardial infarction, and ischemia-driven target vessel revascularization at 1 year after the index procedure.


Results:

Baseline percent diameter stenosis and lesion length were similar in both groups (51 ± 8% and 24 ± 12 mm in the FFR group vs. 52 ± 8% and 24 ± 13 mm in the IVUS group, respectively). However, the IVUS-guided group underwent revascularization therapy significantly more often (91.5% vs. 33.7%, p < 0.001). No significant difference was found in major adverse cardiac event rates between the 2 groups (3.6% in FFR-guided PCI vs. 3.2% in IVUS-guided PCI). Independent predictors for performing intervention were guiding device: FFR versus IVUS (relative risk [RR]: 0.02); left anterior descending coronary artery versus non-left anterior descending coronary artery disease (RR: 5.60); and multi- versus single-vessel disease (RR: 3.28).


Conclusions:

Both FFR- and IVUS-guided PCI strategy for intermediate coronary artery disease were associated with favorable outcomes. The FFR-guided PCI reduces the need for revascularization of many of these lesions.
Keimyung Author(s)(Kor)
남창욱
윤혁준
조윤경
박형섭
김형섭
허승호
김윤년
김권배
정인성
Publisher
School of Medicine
Citation
Chang-Wook Nam et al. (2010). Outcomes of Percutaneous Coronary Intervention in Intermediate Coronary Artery Disease Fractional Flow Reserve–Guided Versus Intravascular Ultrasound–Guided. JACC: Cardiovascular Interventions, 3(8), 812–817. doi: 10.1016/j.jcin.2010.04.016
Type
Article
ISSN
1936-8798
DOI
10.1016/j.jcin.2010.04.016
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33905
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학)
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