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Clinical Value of Single-Projection Angiography-Derived FFR in Noninfarct-Related Artery.
Kwon, Woochan; Choi, Ki Hong; Lee, Seung Hun; Hong, David; Shin, Doosup; Kim, Hyun Kuk; Park, Keun Ho; Choo, Eun Ho; Kim, Chan Joon; Kim, Min Chul; Hong, Young Joon; Ahn, Sung Gyun; Doh, Joon-Hyung; Lee, Sang Yeub; Park, Sang Don; Lee, Hyun-Jong; Kang, Min Gyu; Koh, Jin-Sin; Cho, Yun-Kyeong; Nam, Chang-Wook; Joh, Hyun Sung; Kyu Park, Taek; Yang, Jeong Hoon; Song, Young Bin; Choi, Seung-Hyuk; Jeong, Myung Ho; Gwon, Hyeon-Cheol; Hahn, Joo-Yong; Lee, Joo Myung.
Afiliación
  • Kwon W; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Choi KH; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Lee SH; Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea (S.H.L., M.C.K., Y.J.H., M.H.J.).
  • Hong D; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Shin D; Division of Cardiology, Department of Internal Medicine, Duke University Medical Center, Durham, NC (D.S.).
  • Kim HK; Chosun University Hospital, University of Chosun College of Medicine, Gwangju, South Korea (H.K.K., K.H.P.).
  • Park KH; Chosun University Hospital, University of Chosun College of Medicine, Gwangju, South Korea (H.K.K., K.H.P.).
  • Choo EH; Seoul St. Mary's Hospital, The Catholic University of Korea, South Korea (E.H.C.).
  • Kim CJ; The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Seoul, South Korea (C.J.K.).
  • Kim MC; Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea (S.H.L., M.C.K., Y.J.H., M.H.J.).
  • Hong YJ; Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea (S.H.L., M.C.K., Y.J.H., M.H.J.).
  • Ahn SG; Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, South Korea (S.G.A.).
  • Doh JH; Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea (J.-H.D.).
  • Lee SY; Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, South Korea (S.Y.L.).
  • Park SD; Inha University Hospital, Incheon, South Korea (S.D.P.).
  • Lee HJ; Sejong General Hospital, Bucheon, South Korea (H.-J.L.).
  • Kang MG; Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, South Korea (M.G.K., J.-S.K.).
  • Koh JS; Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, South Korea (M.G.K., J.-S.K.).
  • Cho YK; Keimyung University Dongsan Medical Center, Daegu, South Korea (Y.-K.C., C.-W.N.).
  • Nam CW; Keimyung University Dongsan Medical Center, Daegu, South Korea (Y.-K.C., C.-W.N.).
  • Joh HS; Seoul National University Boramae Medical Center, Seoul National University College of Medicine, South Korea (H.S.J.).
  • Kyu Park T; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Yang JH; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Song YB; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Choi SH; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Jeong MH; Division of Cardiology, Department of Internal Medicine, Heart Center, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea (S.H.L., M.C.K., Y.J.H., M.H.J.).
  • Gwon HC; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Hahn JY; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
  • Lee JM; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (W.K., K.H.C., D.H., T.K.P., J.H.Y., Y.B.S., S.-H.C., H.-C.G., J.-Y.H., J.M.L.).
Circ Cardiovasc Interv ; 17(5): e013844, 2024 May.
Article en En | MEDLINE | ID: mdl-38771911
ABSTRACT

BACKGROUND:

The Murray law-based quantitative flow ratio (µFR) is an emerging technique that requires only 1 projection of coronary angiography with similar accuracy to quantitative flow ratio (QFR). However, it has not been validated for the evaluation of noninfarct-related artery (non-IRA) in acute myocardial infarction (AMI) settings. Therefore, our study aimed to evaluate the diagnostic accuracy of µFR and the safety of deferring non-IRA lesions with µFR >0.80 in the setting of AMI.

METHODS:

µFR and QFR were analyzed for non-IRA lesions of patients with AMI enrolled in the FRAME-AMI trial (Fractional Flow Reserve Versus Angiography-Guided Strategy for Management of Non-Infarction Related Artery Stenosis in Patients With Acute Myocardial Infarction), consisting of fractional flow reserve (FFR)-guided percutaneous coronary intervention and angiography-guided percutaneous coronary intervention groups. The diagnostic accuracy of µFR was compared with QFR and FFR. Patients were classified by the non-IRA µFR value of 0.80 as a cutoff value. The primary outcome was a vessel-oriented composite outcome, a composite of cardiac death, non-IRA-related myocardial infarction, and non-IRA-related repeat revascularization.

RESULTS:

µFR and QFR analyses were feasible in 443 patients (552 lesions). µFR showed acceptable correlation with FFR (R=0.777; P<0.001), comparable C-index with QFR to predict FFR ≤0.80 (µFR versus QFR 0.926 versus 0.961, P=0.070), and shorter total analysis time (mean, 32.7 versus 186.9 s; P<0.001). Non-IRA with µFR >0.80 and deferred percutaneous coronary intervention had a significantly lower risk of vessel-oriented composite outcome than non-IRA with performed percutaneous coronary intervention (3.4% versus 10.5%; hazard ratio, 0.37 [95% CI, 0.14-0.99]; P=0.048).

CONCLUSIONS:

In patients with multivessel AMI, µFR of non-IRA showed acceptable diagnostic accuracy comparable to that of QFR to predict FFR ≤0.80. Deferred non-IRA with µFR >0.80 showed a lower risk of vessel-oriented composite outcome than revascularized non-IRA. REGISTRATION URL https//www.clinicaltrials.gov; Unique identifier NCT02715518.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Valor Predictivo de las Pruebas / Angiografía Coronaria / Vasos Coronarios / Reserva del Flujo Fraccional Miocárdico / Intervención Coronaria Percutánea / Infarto del Miocardio Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Circ Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Valor Predictivo de las Pruebas / Angiografía Coronaria / Vasos Coronarios / Reserva del Flujo Fraccional Miocárdico / Intervención Coronaria Percutánea / Infarto del Miocardio Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Circ Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos