Outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve in subjects with acute coronary syndrome

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• 作者：Andrea Picchi^a ; ¹ ; ^{andre.picchi@gmail.com} ; Antonio Maria Leone^b ; ¹ ; Filippo Zilio^c ; ¹ ; Enrico Cerrato^d ; ¹ ; Fabrizio D'Ascenzo^e ; ¹ ; Massimo Fineschi^f ; ¹ ; Stefano Rigattieri^g ; ¹ ; Marco Ferlini^h ; ¹ ; Matteo Cameli^f ; ¹ ; Paolo Calabria^a ; ¹ ; Alberto Cresti^a ; ¹ ; Ugo Limbruno^a ; ¹
• 关键词：Fractional flow reserve ; Acute coronary syndrome ; Coronary revascularization
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 March 2017
• 年：2017
• 卷：230
• 期：Complete
• 页码：335-338
• 全文大小：202 K
• 卷排序：230

文摘

Revascularization of functionally non-significant stenoses in patients with stable coronary artery disease can safely be deferred as rate of adverse cardiovascular events is low. It is not clear whether fractional flow reserve (FFR) is just as accurate in acute coronary syndromes (ACS). The aim of this study is to assess the outcome of coronary lesions whose revascularization was deferred based on negative FFR values in subjects with ACS.MethodsPatients with acute coronary syndrome and showing at least one coronary stenosis whose revascularization was deferred based on FFR value > 0.80 were included in the study. The primary endpoint of the study was the rate of target lesion failure (TLF), a composite of cardiac events (cardiac death, myocardial infarction and any coronary revascularization) related to the initially deferred stenosis at three-year follow-up.ResultsA total of 319 patients (237 male), mean age 68 [59–74] years and 355 coronary lesions with deferred revascularization based on negative FFR values (0.88 ± 0.05) were selected. The rate of TLF was 6% at 1-year, 9% at 2-year and 12% at 3-year follow-up. TLF was driven by a new acute coronary syndrome in 75% of cases. The median time interval from FFR assessment to TLF was 457 [138–868] days.ConclusionsIn patients with acute coronary syndrome, the rate of TLF of the initially deferred coronary stenoses is 12% at 3-year follow-up and TLF occurred because of a new ACS in three quarters of cases.