Outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve in subjects with acute coronary syndrome

Andrea Picchi, Antonio Maria Leone, Filippo Zilio, Enrico Cerrato, Fabrizio D'Ascenzo, Massimo Fineschi, Stefano Rigattieri, Marco Ferlini, Matteo Cameli, Paolo Calabria, Alberto Cresti, Ugo Limbruno

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 languageEnglish
Pages (from-to)335-338
Number of pages4
JournalInternational Journal of Cardiology
Volume230
DOIs
Publication statusPublished - Mar 1 2017

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Acute Coronary Syndrome
Coronary Stenosis
Pathologic Constriction
Coronary Artery Disease
Myocardial Infarction

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 journalArticle

Picchi, A, Leone, AM, Zilio, F, Cerrato, E, D'Ascenzo, F, Fineschi, M, Rigattieri, S, Ferlini, M, Cameli, M, Calabria, P, Cresti, A & Limbruno, U 2017, 'Outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve in subjects with acute coronary syndrome', International Journal of Cardiology, vol. 230, pp. 335-338. https://doi.org/10.1016/j.ijcard.2016.12.109
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. / Outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve in subjects with acute coronary syndrome. In: International Journal of Cardiology. 2017 ; Vol. 230. pp. 335-338.
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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.",
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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

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