Titre
Fractional flow reserve for the assessment of nonculprit coronary artery stenoses in patients with acute myocardial infarction.
Type
article
Institution
Externe
Périodique
Auteur(s)
Ntalianis, A.
Auteure/Auteur
Sels, J.W.
Auteure/Auteur
Davidavicius, G.
Auteure/Auteur
Tanaka, N.
Auteure/Auteur
Muller, O.
Auteure/Auteur
Trana, C.
Auteure/Auteur
Barbato, E.
Auteure/Auteur
Hamilos, M.
Auteure/Auteur
Mangiacapra, F.
Auteure/Auteur
Heyndrickx, G.R.
Auteure/Auteur
Wijns, W.
Auteure/Auteur
Pijls, N.H.
Auteure/Auteur
De Bruyne, B.
Auteure/Auteur
Liens vers les personnes
ISSN
1876-7605
Statut éditorial
Publié
Date de publication
2010
Volume
3
Numéro
12
Première page
1274
Dernière page/numéro d’article
1281
Peer-reviewed
Oui
Langue
anglais
Résumé
OBJECTIVES: We investigated the reliability of fractional flow reserve (FFR) of nonculprit coronary stenoses during percutaneous coronary intervention (PCI) in acute myocardial infarction.
BACKGROUND: Assessing the hemodynamic severity of the nonculprit coronary artery stenoses at the acute phase of a myocardial infarction could improve risk stratification and shorten the diagnostic work-up.
METHODS: One hundred one patients undergoing PCI for an acute myocardial infarction (n = 75 with ST-segment elevation myocardial infarction [STEMI], and n = 26 with non-ST-segment elevation myocardial infarction) were prospectively recruited. The FFR measurements in 112 nonculprit stenoses were obtained immediately after PCI of the culprit stenosis and were repeated 35 ± 4 days later. In addition, left ventricular ejection fraction, quantitative coronary angiographic measurements of the nonculprit stenoses, Thrombolysis In Myocardial Infarction (TIMI) flow, corrected TIMI frame count (cTFC), and the index of microcirculatory resistance (n = 14) of the nonculprit vessels were assessed in the acute phase and at control angiogram.
RESULTS: The FFR value of the nonculprit stenoses did not change between the acute and follow-up (0.77 ± 0.13 vs. 0.77 ± 0.13, respectively, p = NS). In only 2 patients, the FFR value was higher than 0.8 at the acute phase and lower than 0.75 at follow-up. The TIMI flow, cTFC, percentage diameter stenosis, minimum lumen diameter, and index of microcirculatory resistance did not change. Left ventricular ejection fraction increased significantly in patients with STEMI (from 54 ± 13% to 57 ± 13%, p = 0.03).
CONCLUSIONS: During the acute phase of acute coronary syndromes, the severity of nonculprit coronary artery stenoses can reliably be assessed by FFR. This allows a decision about the need for additional revascularization and might contribute to a better risk stratification.
BACKGROUND: Assessing the hemodynamic severity of the nonculprit coronary artery stenoses at the acute phase of a myocardial infarction could improve risk stratification and shorten the diagnostic work-up.
METHODS: One hundred one patients undergoing PCI for an acute myocardial infarction (n = 75 with ST-segment elevation myocardial infarction [STEMI], and n = 26 with non-ST-segment elevation myocardial infarction) were prospectively recruited. The FFR measurements in 112 nonculprit stenoses were obtained immediately after PCI of the culprit stenosis and were repeated 35 ± 4 days later. In addition, left ventricular ejection fraction, quantitative coronary angiographic measurements of the nonculprit stenoses, Thrombolysis In Myocardial Infarction (TIMI) flow, corrected TIMI frame count (cTFC), and the index of microcirculatory resistance (n = 14) of the nonculprit vessels were assessed in the acute phase and at control angiogram.
RESULTS: The FFR value of the nonculprit stenoses did not change between the acute and follow-up (0.77 ± 0.13 vs. 0.77 ± 0.13, respectively, p = NS). In only 2 patients, the FFR value was higher than 0.8 at the acute phase and lower than 0.75 at follow-up. The TIMI flow, cTFC, percentage diameter stenosis, minimum lumen diameter, and index of microcirculatory resistance did not change. Left ventricular ejection fraction increased significantly in patients with STEMI (from 54 ± 13% to 57 ± 13%, p = 0.03).
CONCLUSIONS: During the acute phase of acute coronary syndromes, the severity of nonculprit coronary artery stenoses can reliably be assessed by FFR. This allows a decision about the need for additional revascularization and might contribute to a better risk stratification.
Sujets
PID Serval
serval:BIB_5F810E1831AF
PMID
Open Access
Oui
Date de création
2015-02-16T16:57:13.708Z
Date de création dans IRIS
2025-05-20T20:26:44Z