Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease
| Autor: | Bernard, De Bruyne, Nico H J, Pijls, Bindu, Kalesan, Emanuele, Barbato, Pim A L, Tonino, Zsolt, Piroth, Nikola, Jagic, Sven, Möbius-Winkler, Sven, Mobius-Winckler, Gilles, Rioufol, Nils, Witt, Petr, Kala, Philip, MacCarthy, Thomas, Engström, Keith G, Oldroyd, Kreton, Mavromatis, Ganesh, Manoharan, Peter, Verlee, Ole, Frobert, Nick, Curzen, Jane B, Johnson, Peter, Jüni, William F, Fearon, D, Nikolic |
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| Přispěvatelé: | De Bruyne, B, Pijls, Nh, Kalesan, B, Barbato, Emanuele, Tonino, Pa, Piroth, Z, Jagic, N, M?bius Winkler, S, Rioufol, G, Witt, N, Kala, P, Maccarthy, P, Engstr?m, T, Oldroyd, Kg, Mavromatis, K, Manoharan, G, Verlee, P, Frobert, O, Curzen, N, Johnson, Jb, J?ni, P, Fearon, Wf, Fame, 2 Trial Investigators, Cardiovascular Biomechanics |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction ComputingMilieux_LEGALASPECTSOFCOMPUTING 610 Medicine & health Angiotensin-Converting Enzyme Inhibitors Coronary Disease Fractional flow reserve Kaplan-Meier Estimate Revascularization Coronary artery disease 360 Social problems & social services Angioplasty Internal medicine medicine Humans Myocardial infarction Angioplasty Balloon Coronary Aged Aspirin business.industry Hazard ratio Coronary Stenosis Percutaneous coronary intervention Drug-Eluting Stents General Medicine Middle Aged medicine.disease Adrenergic beta-1 Receptor Antagonists Combined Modality Therapy Surgery Fractional Flow Reserve Myocardial Conventional PCI Retreatment Cardiology Drug Therapy Combination Female business Platelet Aggregation Inhibitors Follow-Up Studies |
| Zdroj: | De Bruyne, Bernard; Pijls, Nico H J; Kalesan, Bindu; Barbato, Emanuele; Tonino, Pim A L; Piroth, Zsolt; Jagic, Nikola; Möbius-Winkler, Sven; Rioufol, Gilles; Witt, Nils; Kala, Petr; MacCarthy, Philip; Engström, Thomas; Oldroyd, Keith G; Mavromatis, Kreton; Manoharan, Ganesh; Verlee, Peter; Frobert, Ole; Curzen, Nick; Johnson, Jane B; ... (2012). Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. New England journal of medicine NEJM, 367(11), pp. 991-1001. Waltham, Mass.: Massachusetts Medical Society MMS 10.1056/NEJMoa1205361 The New England Journal of Medicine, 367(11), 991-1001. Massachussetts Medical Society |
| ISSN: | 1533-4406 0028-4793 |
| Popis: | A b s t r ac t Background The preferred initial treatment for patients with stable coronary artery disease is the best available medical therapy. We hypothesized that in patients with functionally significant stenoses, as determined by measurement of fractional flow reserve (FFR), percutaneous coronary intervention (PCI) plus the best available medical therapy would be superior to the best available medical therapy alone. Methods In patients with stable coronary artery disease for whom PCI was being considered, we assessed all stenoses by measuring FFR. Patients in whom at least one stenosis was functionally significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus the best available medical therapy (PCI group) or the best available medical therapy alone (medical-therapy group). Patients in whom all stenoses had an FFR of more than 0.80 were entered into a registry and received the best available medical therapy. The primary end point was a composite of death, myocardial infarction, or urgent revascularization. Results Recruitment was halted prematurely after enrollment of 1220 patients (888 who underwent randomization and 332 enrolled in the registry) because of a significant between-group difference in the percentage of patients who had a primary endpoint event: 4.3% in the PCI group and 12.7% in the medical-therapy group (hazard ratio with PCI, 0.32; 95% confidence interval [CI], 0.19 to 0.53; P |
| Databáze: | OpenAIRE |
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