Non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve
Abstract Limited data are available regarding comparative prognosis after percutaneous coronary intervention (PCI) versus deferral of revascularization in patients with intermediate stenosis with abnormal fractional flow reserve (FFR) but preserved coronary flow reserve (CFR). From the International...
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Nature Portfolio
2021
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oai:doaj.org-article:0e6e5b788335437387cdbf4aee77761b2021-12-02T17:39:22ZNon-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve10.1038/s41598-021-88732-42045-2322https://doaj.org/article/0e6e5b788335437387cdbf4aee77761b2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88732-4https://doaj.org/toc/2045-2322Abstract Limited data are available regarding comparative prognosis after percutaneous coronary intervention (PCI) versus deferral of revascularization in patients with intermediate stenosis with abnormal fractional flow reserve (FFR) but preserved coronary flow reserve (CFR). From the International Collaboration of Comprehensive Physiologic Assessment Registry (NCT03690713), a total of 330 patients (338 vessels) who had coronary stenosis with FFR ≤ 0.80 but CFR > 2.0 were selected for the current analysis. Patient-level clinical outcome was assessed by major adverse cardiac events (MACE) at 5 years, a composite of all-cause death, target-vessel myocardial infarction (MI), or target-vessel revascularization. Among the study population, 231 patients (233 vessels) underwent PCI and 99 patients (105 vessels) were deferred. During 5 years of follow-up, cumulative incidence of MACE was 13.0% (31 patients) without significant difference between PCI and deferred groups (12.7% vs. 14.0%, adjusted HR 1.301, 95% CI 0.611–2.769, P = 0.495). Multiple sensitivity analyses by propensity score matching and inverse probability weighting also showed no significant difference in patient-level MACE and vessel-specific MI or revascularization. In this hypothesis-generating study, there was no significant difference in clinical outcomes between PCI and deferred groups among patients with intermediate stenosis with FFR ≤ 0.80 but CFR > 2.0. Further study is needed to confirm this finding. Clinical Trial Registration: International Collaboration of Comprehensive Physiologic Assessment Registry (NCT03690713; registration date: 10/01/2018).Doosup ShinJoo Myung LeeSeung Hun LeeDoyeon HwangKi Hong ChoiHyun Kuk KimJoon-Hyung DohChang-Wook NamEun-Seok ShinMasahiro HoshinoTadashi MuraiTaishi YonetsuHernán Mejía-RenteríaTsunekazu KakutaJavier EscanedBon-Kwon KooNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021) |
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DOAJ |
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Medicine R Science Q Doosup Shin Joo Myung Lee Seung Hun Lee Doyeon Hwang Ki Hong Choi Hyun Kuk Kim Joon-Hyung Doh Chang-Wook Nam Eun-Seok Shin Masahiro Hoshino Tadashi Murai Taishi Yonetsu Hernán Mejía-Rentería Tsunekazu Kakuta Javier Escaned Bon-Kwon Koo Non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve |
| description |
Abstract Limited data are available regarding comparative prognosis after percutaneous coronary intervention (PCI) versus deferral of revascularization in patients with intermediate stenosis with abnormal fractional flow reserve (FFR) but preserved coronary flow reserve (CFR). From the International Collaboration of Comprehensive Physiologic Assessment Registry (NCT03690713), a total of 330 patients (338 vessels) who had coronary stenosis with FFR ≤ 0.80 but CFR > 2.0 were selected for the current analysis. Patient-level clinical outcome was assessed by major adverse cardiac events (MACE) at 5 years, a composite of all-cause death, target-vessel myocardial infarction (MI), or target-vessel revascularization. Among the study population, 231 patients (233 vessels) underwent PCI and 99 patients (105 vessels) were deferred. During 5 years of follow-up, cumulative incidence of MACE was 13.0% (31 patients) without significant difference between PCI and deferred groups (12.7% vs. 14.0%, adjusted HR 1.301, 95% CI 0.611–2.769, P = 0.495). Multiple sensitivity analyses by propensity score matching and inverse probability weighting also showed no significant difference in patient-level MACE and vessel-specific MI or revascularization. In this hypothesis-generating study, there was no significant difference in clinical outcomes between PCI and deferred groups among patients with intermediate stenosis with FFR ≤ 0.80 but CFR > 2.0. Further study is needed to confirm this finding. Clinical Trial Registration: International Collaboration of Comprehensive Physiologic Assessment Registry (NCT03690713; registration date: 10/01/2018). |
| format |
article |
| author |
Doosup Shin Joo Myung Lee Seung Hun Lee Doyeon Hwang Ki Hong Choi Hyun Kuk Kim Joon-Hyung Doh Chang-Wook Nam Eun-Seok Shin Masahiro Hoshino Tadashi Murai Taishi Yonetsu Hernán Mejía-Rentería Tsunekazu Kakuta Javier Escaned Bon-Kwon Koo |
| author_facet |
Doosup Shin Joo Myung Lee Seung Hun Lee Doyeon Hwang Ki Hong Choi Hyun Kuk Kim Joon-Hyung Doh Chang-Wook Nam Eun-Seok Shin Masahiro Hoshino Tadashi Murai Taishi Yonetsu Hernán Mejía-Rentería Tsunekazu Kakuta Javier Escaned Bon-Kwon Koo |
| author_sort |
Doosup Shin |
| title |
Non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve |
| title_short |
Non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve |
| title_full |
Non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve |
| title_fullStr |
Non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve |
| title_full_unstemmed |
Non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve |
| title_sort |
non-randomized comparison between revascularization and deferral for intermediate coronary stenosis with abnormal fractional flow reserve and preserved coronary flow reserve |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/0e6e5b788335437387cdbf4aee77761b |
| work_keys_str_mv |
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