Trends in Outcomes of Revascularization for Left Main Coronary Disease or Three-Vessel Disease With the Routine Incorporation of Fractional Flow Reserve in Real Practice

The American Journal of Cardiology
Jung-Min AhnSeung-Jung Park

Abstract

Impact of fractional flow reserve guidance on revascularization strategies and outcomes for severe coronary artery disease was unclear. We evaluate changes in treatment strategy and clinical outcomes and to compare the effectiveness between percutaneous coronary intervention (PCI) with second-generation drug-eluting stents and coronary artery bypass graft surgery (CABG) in severe coronary artery disease patients before and after routine use of FFR. From January 2008 to December 2011, we enrolled 2,612 patients with significant left main coronary artery disease or 3-vessel disease. We obtained data of patients before (from January 2008 to December 2009) and after (January 2010 to December 2011) the routine use of FFR. We used propensity score matching to compare the rate of primary outcomes (death, myocardial infarction, stroke, or repeat revascularization [Major adverse cardiovascular and cerebral event; MACCE]) at 1 year. Introduction of routine FFR use reduced the proportion of patients receiving CABG from 54% to 43% (p <0.001). The risk of MACCE before routine FFR use was significantly higher in the PCI group than the CABG group (hazard ratio [HR] 1.82, 95% confidence interval [CI] 1.09 to 3.03, p = 0.021), whereas that afte...Continue Reading

References

Sep 28, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·UNKNOWN Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for CardDavid Taggart
May 5, 2011·JAMA : the Journal of the American Medical Association·Andrew J EpsteinPeter W Groeneveld
Mar 17, 2012·Journal of the American College of Cardiology·Nico H J Pijls, Jan-Willem E M Sels
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Nov 6, 2012·The New England Journal of Medicine·Michael E FarkouhUNKNOWN FREEDOM Trial Investigators
Dec 1, 2012·Global Heart·Kristian ThygesenHarvey D White

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Citations

Jan 27, 2016·The Journal of Thoracic and Cardiovascular Surgery·Jack H Boyd
Aug 16, 2016·Journal of the American College of Cardiology·Gabor G TothBernard De Bruyne
Jun 7, 2017·Circulation·Bernard De BruyneEmanuele Barbato
Mar 10, 2016·Circulation·William F Fearon, Robert A Harrington
Feb 6, 2020·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Seung-Jung Park, Jung-Min Ahn
Mar 21, 2018·Korean Circulation Journal·Joo Myung LeeBon Kwon Koo

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