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FFR-Guided Complete...
FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction
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- Bohm, Felix (författare)
- Karolinska Inst, Sweden; Danderyd Hosp, Sweden
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- Mogensen, Brynjolfur (författare)
- Karolinska Inst, Sweden; Danderyd Hosp, Sweden
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- Engstrom, Thomas (författare)
- Univ Copenhagen, Denmark
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- Stankovic, Goran (författare)
- Univ Belgrade, Serbia
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- Srdanovic, Ilija (författare)
- Univ Novi Sad, Serbia
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- Lonborg, Jacob (författare)
- Univ Copenhagen, Denmark
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- Zwackman, Sammy (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Hamid, Mehmet (författare)
- Malarsjukhuset, Sweden
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- Kellerth, Thomas (författare)
- Cent Hosp Karlstad, Sweden
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- Lauermann, Jorg (författare)
- Ryhov Hosp, Sweden
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- Kajander, Olli A. (författare)
- Tampere Univ, Finland; Tampere Univ, Finland
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- Andersson, Jonas (författare)
- Umea Univ Hosp, Sweden
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- Linder, Rikard (författare)
- Karolinska Inst, Sweden; Danderyd Hosp, Sweden
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- Angeras, Oskar (författare)
- Gothenburg Univ, Sweden; Gothenburg Univ, Sweden
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- Renlund, Henrik (författare)
- Uppsala Univ, Sweden
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- Erglis, Andrejs (författare)
- Univ Latvia, Latvia
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- Menon, Madhav (författare)
- Waikato Hosp, New Zealand
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- Schultz, Carl (författare)
- Univ Western Australia, Australia; Royal Perth Hosp, Australia
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- Laine, Mika (författare)
- Helsinki Univ Cent Hosp, Finland
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- Held, Claes (författare)
- Uppsala Univ, Sweden; Uppsala Univ, Sweden
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- Ruck, Andreas (författare)
- Danderyd Hosp, Sweden; Karolinska Univ Hosp, Sweden
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- Ostlund, Ollie (författare)
- Uppsala Univ, Sweden
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- James, Stefan (författare)
- Uppsala Univ, Sweden; Uppsala Univ, Sweden
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: New England Journal of Medicine. - : MASSACHUSETTS MEDICAL SOC. - 0028-4793 .- 1533-4406.
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background The benefit of fractional flow reserve (FFR)-guided complete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease remains unclear.Methods In this multinational, registry-based, randomized trial, we assigned patients with STEMI or very-high-risk non-STEMI (NSTEMI) and multivessel disease who were undergoing primary percutaneous coronary intervention (PCI) of the culprit lesion to receive either FFR-guided complete revascularization of nonculprit lesions or no further revascularization. The primary outcome was a composite of death from any cause, myocardial infarction, or unplanned revascularization. The two key secondary outcomes were a composite of death from any cause or myocardial infarction and unplanned revascularization.Results A total of 1542 patients underwent randomization, with 764 assigned to receive FFR-guided complete revascularization and 778 assigned to receive culprit-lesion-only PCI. At a median follow-up of 4.8 years (interquartile range, 4.3 to 5.2), a primary-outcome event had occurred in 145 patients (19.0%) in the complete-revascularization group and in 159 patients (20.4%) in the culprit-lesion-only group (hazard ratio, 0.93; 95% confidence interval [CI], 0.74 to 1.17; P=0.53). With respect to the secondary outcomes, no apparent between-group differences were observed in the composite of death from any cause or myocardial infarction (hazard ratio, 1.12; 95% CI, 0.87 to 1.44) or unplanned revascularization (hazard ratio, 0.76; 95% CI, 0.56 to 1.04). There were no apparent between-group differences in safety outcomes.Conclusions Among patients with STEMI or very-high-risk NSTEMI and multivessel coronary artery disease, FFR-guided complete revascularization was not shown to result in a lower risk of a composite of death from any cause, myocardial infarction, or unplanned revascularization than culprit-lesion-only PCI at 4.8 years. (Funded by the Swedish Research Council and others; FULL REVASC ClinicalTrials.gov number, NCT02862119.) In a registry-based trial, FFR-guided PCI of nonculprit lesions did not result in a lower risk of a composite of death from any cause, myocardial infarction, or unplanned revascularization than culprit-lesion-only PCI.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Bohm, Felix
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Mogensen, Brynjo ...
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Engstrom, Thomas
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Stankovic, Goran
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Srdanovic, Ilija
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Lonborg, Jacob
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visa fler...
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Zwackman, Sammy
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Hamid, Mehmet
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Kellerth, Thomas
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Lauermann, Jorg
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Kajander, Olli A ...
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Andersson, Jonas
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Linder, Rikard
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Angeras, Oskar
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Renlund, Henrik
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Erglis, Andrejs
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Menon, Madhav
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Schultz, Carl
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Laine, Mika
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Held, Claes
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Ruck, Andreas
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Ostlund, Ollie
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James, Stefan
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