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Fractional flow reserve-guided versus angiography-guided coronary artery bypass graft surgery.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Tóth, Gábor Gellért Bruyne, Bernard De Casselman, Filip Vroey, Frederic De Pyxaras, Stylianos A. Serafino, Luigi Di Praet, Frank Van Mieghem, Carlos A. G. Van Stockman, Bernard Wijns, William Degrieck, Ivan Barbato, Eb. |
| Copyright Year | 2013 |
| Abstract | BACKGROUND Fractional flow reserve (FFR) is well established for patients undergoing percutaneous coronary intervention, yet little is known about candidates for coronary artery bypass graft surgery. METHODS AND RESULTS From 2006 to 2010, we retrospectively included in this registry 627 consecutive patients treated by coronary artery bypass graft surgery having at least 1 angiographically intermediate stenosis. In 429 patients, coronary artery bypass graft surgery was based solely on angiography (angiography-guided group). In 198 patients, at least 1 intermediate stenosis was grafted with an FFR ≤0.80 or deferred with an FFR >0.80 (FFR-guided group). The end point was major adverse cardiovascular events at 3 years, defined as the composite of overall death, myocardial infarction, and target vessel revascularization. The rate of angiographic multivessel disease was similar in the angiography-guided and FFR-guided groups (404 [94.2%] versus 186 [93.9%]; P=0.722). In the FFR-guided group, this was significantly downgraded after FFR measurements to 86.4% (P<0.001 versus before FFR) and was associated with a smaller number of anastomoses (3 [2-3] versus 3 [2-4]; P<0.001) and rate of on-pump surgery (49% versus 69%; P<0.001). At 3 years, major adverse cardiovascular events were not different between the angiography-guided and FFR-guided groups (12% versus 11%; hazard ratio, 1.030; 95% confidence interval, 0.627-1.692; P=0.908). However, the FFR-guided group compared with the angiography-guided group presented a significantly lower rate of angina (Canadian Cardiovascular Society class II-IV, 31% versus 47%; P<0.001). CONCLUSIONS FFR-guided coronary artery bypass graft surgery was associated with a lower number of graft anastomoses and a lower rate of on-pump surgery compared with angiography-guided coronary artery bypass graft surgery. This did not result in a higher event rate during up to 36 months of follow-up and was associated with a lower rate of angina. |
| Starting Page | 2246 |
| Ending Page | 2249 |
| Page Count | 4 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/128/13/1405.full.pdf?download=true |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/early/2013/08/28/CIRCULATIONAHA.113.002740.full.pdf?cited-by=yes&legid=circulationaha%3BCIRCULATIONAHA.113.002740v1 |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/early/2013/08/28/CIRCULATIONAHA.113.002740.full.pdf?download=true |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/early/2013/08/28/CIRCULATIONAHA.113.002740.full.pdf |
| PubMed reference number | 23985788v1 |
| Alternate Webpage(s) | https://doi.org/10.1161/CIRCULATIONAHA.113.002740 |
| DOI | 10.1161/circulationaha.113.002740 |
| Journal | Circulation |
| Volume Number | 128 |
| Issue Number | 13 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Angina Pectoris Cessation of life Confidence Intervals Coronary Artery Bypass Surgery Coronary Artery Disease Follow-Up Report Forty Nine Fractional Flow Reserve of Vessel Myocardial Infarction Patients Percutaneous Coronary Intervention Phase II/III Trial Query Priority - Deferred Registries Small Stenosis Transplanted tissue angiogram revascularization |
| Content Type | Text |
| Resource Type | Article |
