계명대학교 의학도서관 Repository

Clinical Outcomes of Deferred Lesions by IVUS Versus FFR-Guided Treatment Decision

Metadata Downloads
Author(s)
Joo Myung LeeHangyul KimDavid HongDoyeon HwangJinlong ZhangXinyang HuJun JiangChang-Wook NamJoon-Hyung DohBong-Ki LeeWeon KimJinyu HuangFan JiangHao ZhouPeng ChenLijiang TangWenbing JiangXiaomin ChenWenming HeJeehoon KangSung-Gyun AhnMyeong-Ho YoonUng KimYou-Jeong KiEun-Seok ShinKi Hong ChoiTaek Kyu ParkJeong Hoon YangYoung Bin SongSeung-Hyuk ChoiHyeon-Cheol GwonBon-Kwon KooHyo-Soo KimSeung-Jea TahkJian'an WangJoo-Yong Hahn
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Circ Cardiovasc Interv
Issued Date
2023
Volume
16
Issue
12
Keyword
coronary artery diseasecoronary vesselsmyocardial infarctionpercutaneous coronary interventionprognosis
Abstract
Background:
There are limited data regarding the safety of deferral of percutaneous coronary intervention based on intravascular ultrasound (IVUS) findings. The current study sought to compare the prognosis between deferred lesions based on IVUS and fractional flow reserve (FFR)-guided treatment decision.

Methods:
This study is a post hoc analysis of the FLAVOUR randomized trial (Fractional Flow Reserve and Intravascular Ultrasound for Clinical Outcomes in Patients With Intermediate Stenosis) that compared 2-year clinical outcomes between IVUS- and FFR-guided treatment decision on intermediate coronary artery lesions using predefined criteria. In both IVUS and FFR groups, vessels were classified into deferred or revascularized vessels, and patients were classified as those with or without deferred lesions. Vessel-oriented composite outcomes (cardiac death, target vessel myocardial infarction, or target vessel revascularization) in deferred vessels and patient-oriented composite outcomes (death, myocardial infarction, or any revascularization) in patients with deferred lesions were compared between the IVUS and FFR groups.

Results:
A total of 1682 patients and 1820 vessels were analyzed, of which 922 patients and 989 vessels were deferred. At 2 years, there was no difference in the cumulative incidence of vessel-oriented composite outcomes in deferred vessels between IVUS (n=375) and FFR (n=614) groups (3.8% versus 4.1%; hazard ratio, 0.91 [95% CI, 0.47-1.75]; P=0.77). The risk of vessel-oriented composite outcomes was comparable between deferred and revascularized vessels following treatment decision by IVUS (3.8% versus 3.5%; hazard ratio, 1.09 [95% CI, 0.54-2.19]; P=0.81) and FFR (4.1% versus 3.6%; hazard ratio, 1.14 [95% CI, 0.56-2.32]; P=0.72). In comparison of patient-oriented composite outcomes in patients with deferred lesions, there was no significant difference between the IVUS (n=357) and FFR (n=565) groups (6.2% versus 5.9%; hazard ratio, 1.05 [95% CI, 0.61-1.80]; P=0.86).

Conclusions:
In patients with intermediate coronary artery stenosis, deferral of percutaneous coronary intervention based on IVUS-guided treatment decision showed comparable risk of clinical events with FFR-guided treatment decision.

Registration:
URL: https://www.clinicaltrials.gov; Unique identifier: NCT02673424.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1941-7632
Source
https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.123.013308
DOI
10.1161/CIRCINTERVENTIONS.123.013308
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45459
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
공개 및 라이선스
  • 공개 구분공개
  • 엠바고Forever
파일 목록
  • 관련 파일이 존재하지 않습니다.

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.