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FFR-Guided Complete...
FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction
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- Böhm, Felix (author)
- The Department of Cardiology, Karolinska Institute, Danderyd Hospital, Danderyd, Sweden,Karolinska Inst, Sweden; Danderyd Hosp, Sweden
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- Mogensen, Brynjölfur (author)
- The Department of Cardiology, Karolinska Institutet, Danderyd Hospital,Karolinska Inst, Sweden; Danderyd Hosp, Sweden
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- Engstrøm, Thomas (author)
- The Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,Univ Copenhagen, Denmark
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- Stankovic, Goran (author)
- The University Clinical Center of Serbia, The Faculty of Medicine, University of Belgrade, Belgrade, Serbia,Univ Belgrade, Serbia
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- Srdanovic, Ilija (author)
- The Faculty of Medicine, University of Novi Sad, Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia,Univ Novi Sad, Serbia
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- Lønborg, Jacob (author)
- The Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,Univ Copenhagen, Denmark
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- Zwackman, Sammy (author)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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- Hamid, Mehmet (author)
- The Department of Cardiology, Mälarsjukhuset, Eskilstuna, Sweden
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- Kellerth, Thomas (author)
- The Department of Cardiology, Central Hospital, Karlstad, Sweden,Cent Hosp Karlstad, Sweden
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- Lauermann, Jörg (author)
- The Department of Cardiology, Ryhov Hospital, Jönköping, Sweden,Ryhov Hosp, Sweden
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- Kajander, Olli A. (author)
- The Heart Hospital, Tampere University Hospital, The Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland,Tampere Univ, Finland; Tampere Univ, Finland
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- Andersson, Jonas (author)
- Umeå universitet,Kardiologi,Umea Univ Hosp, Sweden
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- Linder, Rikard (author)
- Karolinska Institutet
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- Angerås, Oskar, 1976 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Renlund, Henrik (author)
- The Department of Medical Sciences, Uppsala University, Uppsala, Sweden,Uppsala Univ, Sweden
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- Ērglis, Andrejs (author)
- The Latvian Center of Cardiology, Pauls Stradins Clinical University Hospital, University of Latvia, Riga, Latvia,Univ Latvia, Latvia
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- Menon, Madhav (author)
- The Cardiology Department, Waikato Hospital, Hamilton, New Zealand,Waikato Hosp, New Zealand
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- Schultz, Carl (author)
- The Medical School, University of Western Australia, The Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia,Univ Western Australia, Australia; Royal Perth Hosp, Australia
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- Laine, Mika (author)
- The Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland,Helsinki Univ Cent Hosp, Finland
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- Held, Claes (author)
- The Department of Medical Sciences, Uppsala University, Uppsala, Sweden,Uppsala Univ, Sweden; Uppsala Univ, Sweden
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- Rück, Andreas (author)
- Karolinska Institutet
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- Östlund, Ollie (author)
- The Department of Medical Sciences, Uppsala University, Uppsala, Sweden,Uppsala Univ, Sweden
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- James, Stefan (author)
- The Department of Medical Sciences, Uppsala University, Uppsala, Sweden,Uppsala Univ, Sweden; Uppsala Univ, Sweden
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(creator_code:org_t)
- Massachusetts Medical Society, 2024
- 2024
- English.
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In: New England Journal of Medicine. - : Massachusetts Medical Society. - 0028-4793 .- 1533-4406. ; 390:16, s. 1481-1492
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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https://gup.ub.gu.se...
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Abstract
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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.).
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Böhm, Felix
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Mogensen, Brynjö ...
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Engstrøm, Thomas
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Stankovic, Goran
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Srdanovic, Ilija
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Lønborg, Jacob
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show more...
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Zwackman, Sammy
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Hamid, Mehmet
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Kellerth, Thomas
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Lauermann, Jörg
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Kajander, Olli A ...
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Andersson, Jonas
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Linder, Rikard
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Angerås, Oskar, ...
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Renlund, Henrik
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Ērglis, 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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Rück, Andreas
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Östlund, Ollie
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James, Stefan
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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New England Jour ...
- By the university
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Royal Institute of Technology
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Umeå University
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Linköping University
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University of Gothenburg
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Karolinska Institutet