Abstract
Objective Revascularization of functionally non-significant stenoses in patients with stable coronary artery disease can safely be deferred as rate of adverse cardiovascular events is low. It is not clear whether fractional flow reserve (FFR) is just as accurate in acute coronary syndromes (ACS). The aim of this study is to assess the outcome of coronary lesions whose revascularization was deferred based on negative FFR values in subjects with ACS. Methods Patients with acute coronary syndrome and showing at least one coronary stenosis whose revascularization was deferred based on FFR value > 0.80 were included in the study. The primary endpoint of the study was the rate of target lesion failure (TLF), a composite of cardiac events (cardiac death, myocardial infarction and any coronary revascularization) related to the initially deferred stenosis at three-year follow-up. Results A total of 319 patients (237 male), mean age 68 [59–74] years and 355 coronary lesions with deferred revascularization based on negative FFR values (0.88 ± 0.05) were selected. The rate of TLF was 6% at 1-year, 9% at 2-year and 12% at 3-year follow-up. TLF was driven by a new acute coronary syndrome in 75% of cases. The median time interval from FFR assessment to TLF was 457 [138–868] days. Conclusions In patients with acute coronary syndrome, the rate of TLF of the initially deferred coronary stenoses is 12% at 3-year follow-up and TLF occurred because of a new ACS in three quarters of cases.
| Original language | English |
|---|---|
| Pages (from-to) | 335-338 |
| Number of pages | 4 |
| Journal | International Journal of Cardiology |
| Volume | 230 |
| DOIs | |
| Publication status | Published - Mar 1 2017 |
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Keywords
- Acute coronary syndrome
- Coronary revascularization
- Fractional flow reserve
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve in subjects with acute coronary syndrome. / Picchi, Andrea; Leone, Antonio Maria; Zilio, Filippo; Cerrato, Enrico; D'Ascenzo, Fabrizio; Fineschi, Massimo; Rigattieri, Stefano; Ferlini, Marco; Cameli, Matteo; Calabria, Paolo; Cresti, Alberto; Limbruno, Ugo.
In: International Journal of Cardiology, Vol. 230, 01.03.2017, p. 335-338.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve in subjects with acute coronary syndrome
AU - Picchi, Andrea
AU - Leone, Antonio Maria
AU - Zilio, Filippo
AU - Cerrato, Enrico
AU - D'Ascenzo, Fabrizio
AU - Fineschi, Massimo
AU - Rigattieri, Stefano
AU - Ferlini, Marco
AU - Cameli, Matteo
AU - Calabria, Paolo
AU - Cresti, Alberto
AU - Limbruno, Ugo
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Objective Revascularization of functionally non-significant stenoses in patients with stable coronary artery disease can safely be deferred as rate of adverse cardiovascular events is low. It is not clear whether fractional flow reserve (FFR) is just as accurate in acute coronary syndromes (ACS). The aim of this study is to assess the outcome of coronary lesions whose revascularization was deferred based on negative FFR values in subjects with ACS. Methods Patients with acute coronary syndrome and showing at least one coronary stenosis whose revascularization was deferred based on FFR value > 0.80 were included in the study. The primary endpoint of the study was the rate of target lesion failure (TLF), a composite of cardiac events (cardiac death, myocardial infarction and any coronary revascularization) related to the initially deferred stenosis at three-year follow-up. Results A total of 319 patients (237 male), mean age 68 [59–74] years and 355 coronary lesions with deferred revascularization based on negative FFR values (0.88 ± 0.05) were selected. The rate of TLF was 6% at 1-year, 9% at 2-year and 12% at 3-year follow-up. TLF was driven by a new acute coronary syndrome in 75% of cases. The median time interval from FFR assessment to TLF was 457 [138–868] days. Conclusions In patients with acute coronary syndrome, the rate of TLF of the initially deferred coronary stenoses is 12% at 3-year follow-up and TLF occurred because of a new ACS in three quarters of cases.
AB - Objective Revascularization of functionally non-significant stenoses in patients with stable coronary artery disease can safely be deferred as rate of adverse cardiovascular events is low. It is not clear whether fractional flow reserve (FFR) is just as accurate in acute coronary syndromes (ACS). The aim of this study is to assess the outcome of coronary lesions whose revascularization was deferred based on negative FFR values in subjects with ACS. Methods Patients with acute coronary syndrome and showing at least one coronary stenosis whose revascularization was deferred based on FFR value > 0.80 were included in the study. The primary endpoint of the study was the rate of target lesion failure (TLF), a composite of cardiac events (cardiac death, myocardial infarction and any coronary revascularization) related to the initially deferred stenosis at three-year follow-up. Results A total of 319 patients (237 male), mean age 68 [59–74] years and 355 coronary lesions with deferred revascularization based on negative FFR values (0.88 ± 0.05) were selected. The rate of TLF was 6% at 1-year, 9% at 2-year and 12% at 3-year follow-up. TLF was driven by a new acute coronary syndrome in 75% of cases. The median time interval from FFR assessment to TLF was 457 [138–868] days. Conclusions In patients with acute coronary syndrome, the rate of TLF of the initially deferred coronary stenoses is 12% at 3-year follow-up and TLF occurred because of a new ACS in three quarters of cases.
KW - Acute coronary syndrome
KW - Coronary revascularization
KW - Fractional flow reserve
UR - http://www.scopus.com/inward/record.url?scp=85009374158&partnerID=8YFLogxK
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U2 - 10.1016/j.ijcard.2016.12.109
DO - 10.1016/j.ijcard.2016.12.109
M3 - Article
VL - 230
SP - 335
EP - 338
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -