Titre
Influence of Pathophysiologic Patterns of Coronary Artery Disease on Immediate Percutaneous Coronary Intervention Outcomes.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Collet, C.
Auteure/Auteur
Munhoz, D.
Auteure/Auteur
Mizukami, T.
Auteure/Auteur
Sonck, J.
Auteure/Auteur
Matsuo, H.
Auteure/Auteur
Shinke, T.
Auteure/Auteur
Ando, H.
Auteure/Auteur
Ko, B.
Auteure/Auteur
Biscaglia, S.
Auteure/Auteur
Rivero, F.
Auteure/Auteur
Engstrøm, T.
Auteure/Auteur
Arslani, K.
Auteure/Auteur
Leone, A.M.
Auteure/Auteur
van Nunen, L.X.
Auteure/Auteur
Fearon, W.F.
Auteure/Auteur
Christiansen, E.H.
Auteure/Auteur
Fournier, S.
Auteure/Auteur
Desta, L.
Auteure/Auteur
Yong, A.
Auteure/Auteur
Adjedj, J.
Auteure/Auteur
Escaned, J.
Auteure/Auteur
Nakayama, M.
Auteure/Auteur
Eftekhari, A.
Auteure/Auteur
Zimmermann, F.M.
Auteure/Auteur
Sakai, K.
Auteure/Auteur
Storozhenko, T.
Auteure/Auteur
da Costa, B.R.
Auteure/Auteur
Campo, G.
Auteure/Auteur
West, NEJ
Auteure/Auteur
De Potter, T.
Auteure/Auteur
Heggermont, W.
Auteure/Auteur
Buytaert, D.
Auteure/Auteur
Bartunek, J.
Auteure/Auteur
Berry, C.
Auteure/Auteur
Collison, D.
Auteure/Auteur
Johnson, T.
Auteure/Auteur
Amano, T.
Auteure/Auteur
Perera, D.
Auteure/Auteur
Jeremias, A.
Auteure/Auteur
Ali, Z.
Auteure/Auteur
Pijls, NHJ
Auteure/Auteur
De Bruyne, B.
Auteure/Auteur
Johnson, N.P.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1524-4539
Statut éditorial
Publié
Date de publication
2024-08-20
Volume
150
Numéro
8
Première page
586
Dernière page/numéro d’article
597
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
Diffuse coronary artery disease affects the safety and efficacy of percutaneous coronary intervention (PCI). Pathophysiologic coronary artery disease patterns can be quantified using fractional flow reserve (FFR) pullbacks incorporating the pullback pressure gradient (PPG) calculation. This study aimed to establish the capacity of PPG to predict optimal revascularization and procedural outcomes.
This prospective, investigator-initiated, single-arm, multicenter study enrolled patients with at least one epicardial lesion with an FFR ≤0.80 scheduled for PCI. Manual FFR pullbacks were used to calculate PPG. The primary outcome of optimal revascularization was defined as an FFR ≥0.88 after PCI.
A total of 993 patients with 1044 vessels were included. The mean FFR was 0.68±0.12, PPG 0.62±0.17, and the post-PCI FFR was 0.87±0.07. PPG was significantly correlated with the change in FFR after PCI (r=0.65 [95% CI, 0.61-0.69]; P<0.001) and demonstrated excellent predictive capacity for optimal revascularization (area under the receiver operating characteristic curve, 0.82 [95% CI, 0.79-0.84]; P<0.001). FFR alone did not predict revascularization outcomes (area under the receiver operating characteristic curve, 0.54 [95% CI, 0.50-0.57]). PPG influenced treatment decisions in 14% of patients, redirecting them from PCI to alternative treatment modalities. Periprocedural myocardial infarction occurred more frequently in patients with low PPG (<0.62) compared with those with focal disease (odds ratio, 1.71 [95% CI, 1.00-2.97]).
Pathophysiologic coronary artery disease patterns distinctly affect the safety and effectiveness of PCI. PPG showed an excellent predictive capacity for optimal revascularization and demonstrated added value compared with an FFR measurement.
URL: https://www.clinicaltrials.gov; Unique identifier: NCT04789317.
This prospective, investigator-initiated, single-arm, multicenter study enrolled patients with at least one epicardial lesion with an FFR ≤0.80 scheduled for PCI. Manual FFR pullbacks were used to calculate PPG. The primary outcome of optimal revascularization was defined as an FFR ≥0.88 after PCI.
A total of 993 patients with 1044 vessels were included. The mean FFR was 0.68±0.12, PPG 0.62±0.17, and the post-PCI FFR was 0.87±0.07. PPG was significantly correlated with the change in FFR after PCI (r=0.65 [95% CI, 0.61-0.69]; P<0.001) and demonstrated excellent predictive capacity for optimal revascularization (area under the receiver operating characteristic curve, 0.82 [95% CI, 0.79-0.84]; P<0.001). FFR alone did not predict revascularization outcomes (area under the receiver operating characteristic curve, 0.54 [95% CI, 0.50-0.57]). PPG influenced treatment decisions in 14% of patients, redirecting them from PCI to alternative treatment modalities. Periprocedural myocardial infarction occurred more frequently in patients with low PPG (<0.62) compared with those with focal disease (odds ratio, 1.71 [95% CI, 1.00-2.97]).
Pathophysiologic coronary artery disease patterns distinctly affect the safety and effectiveness of PCI. PPG showed an excellent predictive capacity for optimal revascularization and demonstrated added value compared with an FFR measurement.
URL: https://www.clinicaltrials.gov; Unique identifier: NCT04789317.
PID Serval
serval:BIB_954B5AAE15EC
PMID
Date de création
2024-05-16T13:50:31.089Z
Date de création dans IRIS
2025-05-21T02:17:13Z
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38742491_BIB_954B5AAE15EC.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by-nc-nd/4.0
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Format
Adobe PDF
PID Serval
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URN
urn:nbn:ch:serval-BIB_954B5AAE15EC8
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