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Sökning: onr:"swepub:oai:DiVA.org:oru-68331" > Five-Year Outcomes ...

Five-Year Outcomes with PCI Guided by Fractional Flow Reserve

Xaplanteris, P. (författare)
Cardiovascular Center Aalst, Onze-Lieve-Vrouw Clinic, Aalst, Belgium
Fournier, S. (författare)
Cardiovascular Center Aalst, Onze-Lieve-Vrouw Clinic, Aalst, Belgium
Pijls, N. H. J. (författare)
Department of Cardiology, Eindhoven University of Technology, Catharina Hospital, Eindhoven, Netherlands
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Fearon, W. F. (författare)
Stanford University Medical Center and Palo Alto Veterans Affairs (VA) Health Care Systems, Stanford CA, United States
Barbato, E. (författare)
Cardiovascular Center Aalst, Onze-Lieve-Vrouw Clinic, Aalst, Belgium
Tonino, P. A. L. (författare)
Department of Cardiology, Eindhoven University of Technology, Catharina Hospital, Eindhoven, Netherlands
Engström, T. (författare)
Rigshospitalet University Hospital, D-Copenhagen, Germany
Kääb, S. (författare)
Klinikum Der Universitat Munchen-Campus-Innenstadt, Munich, Germany
Dambrink, J-H (författare)
Isala Klinieken, Zwolle, Netherlands
Rioufol, G. (författare)
Cardiovascular Hospital, Lyon, France
Toth, G. G. (författare)
Cardiovascular Center Aalst, Onze-Lieve-Vrouw Clinic, Aalst, Belgium; Gottsegen Hungarian Institute of Cardiology, Budapest, Hungary
Piroth, Z. (författare)
Gottsegen Hungarian Institute of Cardiology, Budapest, Hungary
Witt, N. (författare)
Karolinska Institutet
Fröbert, Ole, 1964- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper
Kala, P. (författare)
Masaryk University and University Hospital, Brno, Czech Republic
Linke, A. (författare)
Heart Center Leipzig, Leipzig, Germany; Heart Center Dresden, Dresden, Germany
Jagic, N. (författare)
Clinical Center Kragujevac, Kragujevac, Serbia
Mates, M. (författare)
Na Homolce Hospital, Prague, Czech Republic
Mavromatis, K. (författare)
Atlanta VA Medical Center, Decatur, United States
Samady, H. (författare)
Emory University School of Medicine, Atlanta GA, USA
Irimpen, A. (författare)
Vascular Institute, Tulane University Heart, New Orleans, United States
Oldroyd, K. (författare)
Golden Jubilee National Hospital, Glasgow, United Kingdom
Campo, G. (författare)
Gruppo Villa Maria Care and Research, Cardiology Unit, Maria Cecilia Hospital, Ravenna, Italy; Azienda Ospedalieria Universitaria di Ferrara, Ferrara, Italy
Rothenbuhler, M. (författare)
Clinical Trials Unit Bern, University of Bern, Bern, Switzerland
Jüni, P. (författare)
Applied Health Research Centre, Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada
De Bruyne, B. (författare)
Cardiovascular Center Aalst, Onze-Lieve-Vrouw Clinic, Aalst, Belgium
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 (creator_code:org_t)
Massachussetts Medical Society, 2018
2018
Engelska.
Ingår i: New England Journal of Medicine. - : Massachussetts Medical Society. - 0028-4793 .- 1533-4406. ; 379:3, s. 250-259
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
http://kipublication...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • BACKGROUND: We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease.METHODS: Among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, <= 0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy and were entered into a registry. The primary end point was a composite of death, myocardial infarction, or urgent revascularization.RESULTS: A total of 888 patients underwent randomization (447 patients in the PCI group and 441 in the medical-therapy group). At 5 years, the rate of the primary end point was lower in the PCI group than in the medical-therapy group (13.9% vs. 27.0%; hazard ratio, 0.46; 95% confidence interval (CIS, 0.34 to 0.63; P<0.001). The difference was driven by urgent revascularizations, which occurred in 6.3% of the patients in the PCI group as compared with 21.1% of those in the medical-therapy group (hazard ratio, 0.27; 95% CI, 0.18 to 0.41). There were no significant differences between the PCI group and the medical-therapy group in the rates of death (5.1% and 5.2%, respectively; hazard ratio, 0.98; 95% CI, 0.55 to 1.75) or myocardial infarction (8.1% and 12.0%; hazard ratio, 0.66; 95% CI, 0.43 to 1.00). There was no significant difference in the rate of the primary end point between the PCI group and the registry cohort (13.9% and 15.7%, respectively; hazard ratio, 0.88; 95% CI, 0.55 to 1.39). Relief from angina was more pronounced after PCI than after medical therapy.CONCLUSIONS: In patients with stable coronary artery disease, an initial FFR-guided PCI strategy was associated with a significantly lower rate of the primary composite end point of death, myocardial infarction, or urgent revascularization at 5 years than medical therapy alone. Patients without hemodynamically significant stenoses had a favorable long-term outcome with medical therapy alone.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)

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