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Sökning: onr:"swepub:oai:lup.lub.lu.se:89dc4809-6313-43d5-84fd-9c615771b816" > Instantaneous wave-...

Instantaneous wave-free ratio versus fractional flow reserve to guide PCI

Götberg, Matthias, (författare)
Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
Christiansen, Evald H., (författare)
the Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
Gudmundsdottir, Ingibjörg J., (författare)
the Department of Cardiology, Reykjavik University Hospital, Reykjavik, Iceland
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Sandhall, Lennart, (författare)
the Departments of Cardiology and Radiology, Helsingborg Hospital, Helsingborg, Sweden
Danielewicz, Mikael, (författare)
the Department of Cardiology, Karlstad Hospital, Karlstad, Sweden
Jakobsen, Lars, (författare)
the Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
Olsson, Sven-Erik, (författare)
the Departments of Cardiology and Radiology, Helsingborg Hospital, Helsingborg, Sweden
Öhagen, Patrik, (författare)
the Uppsala Clinical Research Center, Uppsala, Sweden
Olsson, Hans, (författare)
the Department of Cardiology, Karlstad Hospital, Karlstad, Sweden
Omerovic, Elmir, (författare)
the Department of Cardiology, Sahlgrenska University, Gothenburg, Sweden
Calais, Fredrik, 1971- (författare)
Örebro universitet, Institutionen för medicinska vetenskaper, Region Örebro län, Department of Cardiology, Örebro University Hospital, Örebro, Sweden
Lindroos, Pontus, (författare)
the Department of Cardiology, St. Göran Hospital, Stockholm, Sweden
Maeng, Michael, (författare)
the Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
Tödt, Tim, (författare)
Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
Venetsanos, Dimitrios, (författare)
the Departments of Cardiology and of Medical and Health Sciences, Linköping University, Linköping, Sweden
James, Stefan K., (författare)
Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Kåregren, Amra, (författare)
the Department of Internal Medicine, Västmanland Hospital, Västerås, Sweden
Nilsson, Margareta, (författare)
Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
Carlsson, Jörg, (författare)
the Department of Cardiology, Kalmar County Hospital, and Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
Hauer, Dario, (författare)
the Departments of Cardiology and of Medical and Health Sciences, Linköping University, Linköping, Sweden
Jensen, Jens, (författare)
the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet,Stockholm Sweden; the Unit of Cardiology, Capio St. Görans Sjukhus, Stockholm, Sweden; the Department of Medicine, Sundsvall Hospital, Sundsvall, Sweden
Karlsson, Ann-Charlotte, (författare)
the Department of Cardiology, Halmstad Hospital, Halmstad, Sweden
Panayi, Georgios, (författare)
the Departments of Cardiology and of Medical and Health Sciences, Linköping University, Linköping, Sweden
Erlinge, David, (författare)
Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
Fröbert, Ole, 1964- (författare)
Region Örebro län, Örebro universitet, Institutionen för medicinska vetenskaper, Department of Cardiology, Örebro University Hospital, Örebro, Sweden
iFR-SWEDEHEART Investigators, Group author (författare)
Gotberg, M., (författare)
Lund University
Ohagen, P., (författare)
Uppsala University
Todt, T., (författare)
Lund Univ, Skåne Univ Hosp
Karegren, A., (författare)
Västmanland Hosp Västerås
Frobert, O., (författare)
Örebro University
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Örebro universitet Institutionen för medicinska vetenskaper. (creator_code:org_t)
Region Örebro län (creator_code:org_t)
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Linnéuniversitetet Fakulteten för Hälso- och livsvetenskap (FHL). Institutionen för hälso- och vårdvetenskap (HV). (creator_code:org_t)
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm. Uppsala kliniska forskningscentrum (UCR). (creator_code:org_t)
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet. Medicinska fakulteten. Institutionen för medicinska vetenskaper. Kardiologi. (creator_code:org_t)
Linköpings universitet Institutionen för medicin och hälsa. Avdelningen för kardiovaskulär medicin. (creator_code:org_t)
Linköpings universitet Medicinska fakulteten. (creator_code:org_t)
Region Östergötland Hjärt- och Medicincentrum. Kardiologiska kliniken US. (creator_code:org_t)
Lunds universitet Kardiologi. (creator_code:org_t)
Lunds universitet Kliniska Vetenskaper, Helsingborg. (creator_code:org_t)
Lunds universitet Institutionen för translationell medicin. (creator_code:org_t)
Göteborgs universitet Sahlgrenska akademin. Institutionen för medicin, avdelningen för molekylär och klinisk medicin. 
Örebro universitet Institutionen för medicinska vetenskaper. (creator_code:org_t)
Örebro universitet Institutionen för medicinska vetenskaper. (creator_code:org_t)
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2017
Engelska 11 s.
Ingår i: New England Journal of Medicine. - Massachusetts Medical Society. - 0028-4793. ; 376:19, s. 1813-1823
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • BACKGROUND The instantaneous wave-free ratio (iFR) is an index used to assess the severity of coronary-artery stenosis. The index has been tested against fractional flow reserve (FFR) in small trials, and the two measures have been found to have similar diagnostic accuracy. However, studies of clinical outcomes associated with the use of iFR are lacking. We aimed to evaluate whether iFR is noninferior to FFR with respect to the rate of subsequent major adverse cardiac events. METHODS We conducted a multicenter, randomized, controlled, open-label clinical trial using the Swedish Coronary Angiography and Angioplasty Registry for enrollment. A total of 2037 participants with stable angina or an acute coronary syndrome who had an indication for physiologically guided assessment of coronary-artery stenosis were randomly assigned to undergo revascularization guided by either iFR or FFR. The primary end point was the rate of a composite of death from any cause, nonfatal myocardial infarction, or unplanned revascularization within 12 months after the procedure. RESULTS A primary end-point event occurred in 68 of 1012 patients (6.7%) in the iFR group and in 61 of 1007 (6.1%) in the FFR group (difference in event rates, 0.7 percentage points; 95% confidence interval [CI], -1.5 to 2.8; P = 0.007 for noninferiority; hazard ratio, 1.12; 95% CI, 0.79 to 1.58; P = 0.53); the upper limit of the 95% confidence interval for the difference in event rates fell within the prespecified noninferiority margin of 3.2 percentage points. The results were similar among major subgroups. The rates of myocardial infarction, target-lesion revascularization, restenosis, and stent thrombosis did not differ significantly between the two groups. A significantly higher proportion of patients in the FFR group than in the iFR group reported chest discomfort during the procedure. CONCLUSIONS Among patients with stable angina or an acute coronary syndrome, an iFR-guided revascularization strategy was noninferior to an FFR-guided revascularization strategy with respect to the rate of major adverse cardiac events at 12 months.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmän medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Family Medicine (hsv//eng)

Nyckelord

Cardiology
Kardiologi
Health and Caring Sciences
Hälsovetenskap
Acute Coronary Syndrome
diagnostic imaging
physiopathology
Aged
Angina Pectoris
diagnostic imaging
physiopathology
Cardiovascular Diseases
mortality
Coronary Angiography
Coronary Stenosis
complications
diagnostic imaging
physiopathology
therapy
Female
Follow-Up Studies
Fractional Flow Reserve
Myocardial
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction
epidemiology
Percutaneous Coronary Intervention
methods
Retreatment
Severity of Illness Index

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