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Clinical implications of three-vessel fractional flow reserve measurement in patients with coronary artery disease

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Author(s)
Junqing YangJiyan ChenNobuhiro TanakaHiroyoshi YokoiHitoshi MatsuoHiroaki TakashimaYasutsugu ShionoTakashi AkasakaShaoliang ChenJoo Myung LeeBon-Kwon KooEun-Seok ShinChang-Wook NamJoon-Hyung DohDoyeon HwangJonghanne ParkKyung-Jin KimJinlong ZhangXinyang HuJianAnWangChul AhnFei Ye
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
European Heart Journal
Issued Date
2018
Volume
39
Issue
11
Keyword
Coronary artery diseaseIschaemiaFractional flow reservePrognosis
Abstract
Aims:

There are limited data on the clinical implications of total physiologic atherosclerotic burden assessed by invasive physiologic studies in patients with coronary artery disease. We investigated the prognostic implications of total physiologic atherosclerotic burden assessed by total sum of fractional flow reserve (FFR) in three vessels (3V-FFR).

Methods and results:

A total of 1136 patients underwent FFR measurement in three vessels (3V FFR-FRIENDS study, NCT01621438). The patients were classified into high and low 3V-FFR groups according to the median value of 3V-FFR (2.72). The primary endpoint was major adverse cardiac events (MACE, a composite of cardiac death, myocardial infarction and ischaemia-driven revascularization) at 2 years. Mean angiographic percent diameter stenosis and FFR were 43.7 ± 19.3% and 0.90 ± 0.08, respectively. There was a negative correlation between 3V-FFR and estimated 2-year MACE rate (P < 0.001). The patients in low 3V-FFR group showed a higher risk of 2-year MACE than those in the high 3V-FFR group [(7.1% vs. 3.8%, hazard ratio (HR) 2.205, 95% confidence interval (CI) 1.201-4.048, P = 0.011]. The higher 2-year MACE rate was mainly driven by the higher rate of ischaemia-driven revascularization in the low 3V-FFR group (6.2% vs. 2.7%, HR 2.568, 95% CI 1.283-5.140, P = 0.008). In a multivariable adjusted model, low 3V-FFR was an independent predictor of MACE (HR 2.031, 95% CI 1.078-3.830, P = 0.029).

Conclusion:

Patients with high total physiologic atherosclerotic burden assessed by 3V-FFR showed higher risk of 2-year clinical events than those with low total physiologic atherosclerotic burden. The difference was mainly driven by ischaemia-driven revascularization for both functionally significant and insignificant lesions at baseline. Three-vessel FFR might be used as a prognostic indicator in patients with coronary artery disease.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine (의과대학)
Citation
Junqing Yang et al. (2018). Clinical implications of three-vessel fractional flow reserve measurement in patients with coronary artery disease. European Heart Journal, 39(11), 945–945. doi: 10.1093/eurheartj/ehx458
Type
Article
ISSN
0195-668X
DOI
10.1093/eurheartj/ehx458
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41121
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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