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SHR Neuro Cancer Cardio Lipid Metab Microb

Fournier, S; Collet, C; Xaplanteris, P; Zimmermann, FM; Toth, GG; Tonino, PAL; Pijls, NHJ; Colaiori, I; Di Gioia, G; Barbato, E; Jüni, P; Fearon, WF; De Bruyne, B.
Global Fractional Flow Reserve Value Predicts 5-Year Outcomes in Patients With Coronary Atherosclerosis But Without Ischemia.
J Am Heart Assoc. 2020; 9(24): e017729-e017729. Doi: 10.1161/JAHA.120.017729 [OPEN ACCESS]
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Co-authors Med Uni Graz: Toth-Gayor Gabor
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Abstract:: Background Global fractional flow reserve (FFR) (ie, the sum of the FFR values in the 3 major coronary arteries) is a physiologic correlate of global atherosclerotic burden. The objective of the present study was to investigate the value of global FFR in predicting long-term clinical outcome of patients with stable coronary artery disease but no ischemia-inducing stenosis. Methods and Results We studied major adverse cardiovascular events (MACEs: all-cause death, myocardial infarction, and any revascularization) after 5 years in 1122 patients without significant stenosis (all FFR >0.80; n=275) or with at least 1 significant stenosis successfully treated by percutaneous coronary intervention (ie, post-percutaneous coronary intervention FFR >0.80; n=847). The patients were stratified into low, mid, or high tertiles of global FFR (≤2.80, 2.80-2.88, and ≥2.88). Patients in the lowest tertile of global FFR showed the highest 5-year MACE rate compared with those in the mid or high tertile of global FFR (27.5% versus 22.0% and 20.9%, respectively; log-rank P=0.040). The higher 5-year MACE rate was mainly driven by a higher rate of revascularization in the low global FFR group (16.4% versus 11.3% and 11.8%, respectively; log-rank P=0.038). In a multivariable model, an increase in global FFR of 0.1 unit was associated with a significant reduction in the rates of MACE (hazard ratio [HR], 0.988; 95% CI, 0.977-0.998; P=0.023), myocardial infarction (HR, 0.982; 95% CI, 0.966-0.998; P=0.032), and revascularization (HR, 0.985; 95% CI, 0.972-0.999; P=0.040). Conclusions Even in the absence of ischemia-producing stenoses, patients with a low global FFR, physiologic correlate of global atherosclerotic burden, present a higher risk of MACE at 5-year follow-up.
Find related publications in this database (using NLM MeSH Indexing): Aged -; Atherosclerosis - complications; Atherosclerosis - pathology; Cardiovascular Diseases - epidemiology; Case-Control Studies -; Cause of Death - trends; Coronary Angiography - methods; Coronary Artery Disease - physiopathology; Coronary Artery Disease - surgery; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Cost of Illness -; Female -; Follow-Up Studies -; Fractional Flow Reserve, Myocardial - physiology; Humans -; Male -; Middle Aged -; Myocardial Infarction - epidemiology; Myocardial Revascularization - statistics & numerical data; Percutaneous Coronary Intervention - methods; Predictive Value of Tests -; Prognosis -; Prospective Studies -; Risk Assessment -; Time Factors -
Find related publications in this database (Keywords): coronary atherosclerosis; fractional flow reserve; percutaneous coronary intervention