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Influence of Anatomical and Clinical Characteristics on Long-Term Prognosis of FFR-Guided Deferred Coronary Lesions

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Author(s)
Yun-Kyeong ChoJongmin HwangCheol Hyun LeeIn-Cheol KimHyoung-Seob ParkHyuck-Jun YoonHyungseop KimSeong-Wook HanSeung-Ho HurKwon-Bae KimJin Young KimJoon-Hyung DohEun-Seok ShinBon-Kwon KooChang Wook Nam
Keimyung Author(s)
Cho, Yun KyeongHwang, Jong MinLee, Cheol HyunKim, In CheolPark, Hyoung SeobYoon, Hyuck JunKim, Hyung SeopHan, Seong WookHur, Seung HoKim, Kwon BaeKim, Jin YoungNam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Dept. of Radiology (영상의학)
Journal Title
JACC: Cardiovascular interventions
Issued Date
2020
Volume
13
Issue
16
Keyword
fractional flow reserveintravascular ultrasoundprognosis
Abstract
Objectives:
The aim of this study was to evaluate the clinical and anatomical features to predict the long-term outcomes in patients with fractional flow reserve (FFR)–guided deferred lesions, verified by intravascular ultrasound (IVUS).

Background:
Deferral of nonsignificant lesion by FFR is associated with a low risk of clinical events. However, the impact of combined information on clinical and anatomical factors is not well known.

Methods:
The study included 459 patients with 552 intermediate lesions who had deferred revascularization on the basis of a nonischemic FFR (>0.80). Grayscale IVUS was examined simultaneously. The primary endpoint was patient-oriented composite outcome (POCO) (a composite of all-cause death, myocardial infarction, and any revascularization) during 5-year follow-up.

Results:
The rate of 5-year POCO was 9.8%. Diabetes mellitus (hazard ratio: 3.50; 95% confidence interval [CI]: 1.86 to 6.57; p < 0.001), left ventricular ejection fraction ≤40% (hazard ratio: 4.80; 95% CI: 1.57 to 14.63; p = 0.006), and positive remodeling (hazard ratio: 2.04; 95% CI: 1.03 to 4.03; p = 0.041) were independent predictors for POCO. When the lesions were classified according to the presence of the adverse clinical characteristics (diabetes, left ventricular ejection fraction ≤40%) or adverse plaque characteristics (positive remodeling, plaque burden ≥70%), the risk of POCO was incrementally increased (4.3%, 13.6%, and 21.3%, respectively; p < 0.001).

Conclusions:
In patients with FFR-guided deferred lesions, 5-year clinical outcomes were excellent. Lesion-related anatomical factors from intravascular imaging as well as patient-related clinical factors could provide incremental information about future clinical risks.
Keimyung Author(s)(Kor)
조윤경
황종민
이철현
김인철
박형섭
윤혁준
김형섭
한성욱
허승호
김권배
김진영
남창욱
Publisher
School of Medicine (의과대학)
Citation
Yun-Kyeong Cho et al. (2020). Influence of Anatomical and Clinical Characteristics on Long-Term Prognosis of FFR-Guided Deferred Coronary Lesions. JACC: Cardiovascular interventions, 13(16), 1907–1916. doi: 10.1016/j.jcin.2020.05.040
Type
Article
ISSN
1876-7605
Source
https://www.sciencedirect.com/science/article/pii/S1936879820312413
DOI
10.1016/j.jcin.2020.05.040
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43208
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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