계명대학교 의학도서관 Repository

Combined Assessment of FFR and CFRfor Decision Making in CoronaryRevascularization: From the Multicenter International ILIAS Registry

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Author(s)
Tim P. van de HoefJoo Myung LeeCoen K. M. BoerhoutGuus A. de WaardJi-Hyun JungSeung Hun LeeHernán Mejía-RenteríaMasahiro HoshinoMauro Echavarria-PintoMartijn MeuwissenHitoshi MatsuoMaribel Madera-CamberoAshkan EftekhariMohamed A. EffatTadashi MuraiKoen MarquesJoon-Hyung DohEvald H. ChristiansenRupak BanerjeeChang-Wook NamGiampaolo NiccoliMasafumi NakayamaNobuhiro TanakaEun-Seok ShinNielsvan RoyenSteven A. J. ChamuleauPaul KnaapenJavier EscanedTsunekazu KakutaBon Kwon KooJan J. Piek
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
JACC Cardiovasc Interv
Issued Date
2022
Volume
15
Issue
10
Keyword
coronary flow reservefractional flow reservepercutaneous coronary intervention
Abstract
Objectives:
The aim of this study was to demonstrate the clinical implications of combined assessment of fractional flow reserve (FFR) and coronary flow reserve (CFR).

Background:
Combined assessment of FFR and CFR allows detailed characterization of pathophysiology in chronic coronary syndromes. Data on the clinical implications of distinct FFR and CFR patterns are limited, leading to uncertainty regarding their relevance.

Methods:
Patients with chronic coronary syndromes and obstructive coronary artery disease were selected from the multicenter ILIAS (Inclusive Invasive Physiological Assessment in Angina Syndromes) registry. Patients were classified into 4 groups on the basis of FFR ≤0.80 and CFR <2.0. The endpoint was the 5-year target vessel failure (TVF) rate.

Results:
A total of 2,143 patients with 2,725 lesions were included. Compared with normal FFR/normal CFR, low FFR/low CFR carried the highest risk for TVF (HR: 5.4; 95% CI: 3.2-9.3; P < 0.001), significantly higher than in revascularized vessels (P = 0.007). Discordance, with either low FFR/normal CFR or normal FFR/low CFR, was associated with increased TVF rates compared with normal FFR/normal CFR (low FFR/normal CFR: HR: 3.5 [95% CI: 2.2-5.4; P < 0.001]; normal FFR/low CFR: HR: 3.0 [95% CI: 1.9-4.7; P < 0.001]). No difference in 5-year TVF was observed between the 2 discordant groups (P = 0.57) or between the discordant groups and the revascularized group (P = 0.26 vs low FFR/normal CFR; P = 0.60 vs normal FFR/low CFR).

Conclusions:
Impaired coronary hemodynamics are uniformly associated with increased 5-year TVF rates. Nonrevascularized vessels with discordant FFR and CFR are associated with 5-year event rates that are equivalent to those of vessels that undergo revascularization, whereas vessels with combined low FFR and CFR exhibit event rates that are significantly higher than after revascularization. (Inclusive Invasive Physiological Assessment in Angina Syndromes Registry [ILIAS Registry]; NCT04485234)
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine (의과대학)
Citation
Tim P. van de Hoef et al. (2022). Combined Assessment of FFR and CFRfor Decision Making in CoronaryRevascularization: From the Multicenter International ILIAS Registry. JACC Cardiovasc Interv, 15(10), 1047–1056. doi: 10.1016/j.jcin.2022.03.016
Type
Article
ISSN
1936-8798
Source
https://www.sciencedirect.com/science/article/pii/S1936879822006227
DOI
10.1016/j.jcin.2022.03.016
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44336
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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