Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI

In this trial involving 2492 patients, coronary revascularization guided by iFR, as compared with fractional flow reserve-guided revascularization, was within the prespecified margin for noninferiority with respect to major adverse cardiac events. For the past 20 years, physiological measurements ob...

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Vydáno v:	The New England journal of medicine Ročník 376; číslo 19; s. 1824 - 1834
Hlavní autoři:	Davies, Justin E, Sen, Sayan, Dehbi, Hakim-Moulay, Al-Lamee, Rasha, Petraco, Ricardo, Nijjer, Sukhjinder S, Bhindi, Ravinay, Lehman, Sam J, Walters, Darren, Sapontis, James, Janssens, Luc, Vrints, Christiaan J, Khashaba, Ahmed, Laine, Mika, Van Belle, Eric, Krackhardt, Florian, Bojara, Waldemar, Going, Olaf, Härle, Tobias, Indolfi, Ciro, Niccoli, Giampaolo, Ribichini, Flavo, Tanaka, Nobuhiro, Yokoi, Hiroyoshi, Takashima, Hiroaki, Kikuta, Yuetsu, Erglis, Andrejs, Vinhas, Hugo, Canas Silva, Pedro, Baptista, Sérgio B, Alghamdi, Ali, Hellig, Farrel, Koo, Bon-Kwon, Nam, Chang-Wook, Shin, Eun-Seok, Doh, Joon-Hyung, Brugaletta, Salvatore, Alegria-Barrero, Eduardo, Meuwissen, Martijin, Piek, Jan J, van Royen, Niels, Sezer, Murat, Di Mario, Carlo, Gerber, Robert T, Malik, Iqbal S, Sharp, Andrew S.P, Talwar, Suneel, Tang, Kare, Samady, Habib, Altman, John, Seto, Arnold H, Singh, Jasvindar, Jeremias, Allen, Matsuo, Hitoshi, Kharbanda, Rajesh K, Patel, Manesh R, Serruys, Patrick, Escaned, Javier
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Massachusetts Medical Society 11.05.2017
Témata:	Acute Coronary Syndrome - diagnostic imaging Acute Coronary Syndrome - physiopathology Aged Angina Pectoris - diagnostic imaging Angina Pectoris - physiopathology Angioplasty Cardiology Cardiovascular disease Cardiovascular Diseases - mortality Clinical outcomes Clinical trials Coronary Angiography Coronary artery Coronary Stenosis - diagnostic imaging Coronary Stenosis - physiopathology Coronary Stenosis - therapy Female Follow-Up Studies Fractional Flow Reserve, Myocardial Humans Kaplan-Meier Estimate Male Middle Aged Myocardial Infarction - epidemiology Patients Percutaneous Coronary Intervention - methods Retreatment Severity of Illness Index
ISSN:	0028-4793, 1533-4406, 1533-4406
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Popis
Shrnutí:	In this trial involving 2492 patients, coronary revascularization guided by iFR, as compared with fractional flow reserve-guided revascularization, was within the prespecified margin for noninferiority with respect to major adverse cardiac events. For the past 20 years, physiological measurements obtained during invasive procedures have been used to guide coronary revascularization. Pioneering work supported the use of flow measurements to make safe decisions about revascularization, 1 , 2 but this approach was soon superseded by the use of fractional flow reserve (FFR), which measures pressure as a surrogate of flow to estimate the severity of stenosis. 3 – 5 FFR was successful largely because of its technical simplicity and because clinical trials showed that it was associated with improved clinical outcomes after percutaneous coronary intervention (PCI). 6 , 7 Consequently, FFR is now included in the appropriate-use criteria for . . .
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	0028-4793 1533-4406 1533-4406
DOI:	10.1056/NEJMoa1700445