Long-Term Clinical Outcomes of Fractional Flow Reserve-Guided Versus Routine Drug-Eluting Stent Implantation in Patients With Intermediate Coronary Stenosis Five-Year Clinical Outcomes of DEFER-DES Trialopen access
- Authors
- Park, Sang Hyun; Jeon, Ki-Hyun; Lee, Joo Myung; Nam, Chang-Wook; Doh, Joon-Hyung; Lee, Bong-Ki; Rha, Seung-Woon; Yoo, Ki-dong; Jung, Kyung Tae; Cho, Young-Seok; Lee, Hae-Young; Youn, Tae-Jin; Chung, Woo-Young; Koo, Bon-Kwon
- Issue Date
- Dec-2015
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- coronary artery disease; coronary stenosis; drug-eluting stents; myocardial fractional flow reserve; percutaneous coronary intervention
- Citation
- CIRCULATION-CARDIOVASCULAR INTERVENTIONS, v.8, no.12
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- CIRCULATION-CARDIOVASCULAR INTERVENTIONS
- Volume
- 8
- Number
- 12
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/7314
- DOI
- 10.1161/CIRCINTERVENTIONS.115.002442
- ISSN
- 1941-7640
1941-7632
- Abstract
- Background We aimed to compare the long-term clinical outcomes between fractional flow reserve (FFR)-guided and routine drug-eluting stent (DES) implantation in patients with an intermediate coronary stenosis. Methods and Results A total of 229 patients with an angiographically intermediate coronary stenosis were randomly assigned to FFR-guided or Routine-DES implantation group. For FFR-guided group (n=114), treatment strategy was determined according to the target vessel FFR (FFR<0.75: DES implantation [FFR-DES group]; FFR0.75: deferral of stenting [FFR-Defer group]). Routine-DES group underwent DES implantation without FFR measurement (n=115). The primary end point was the incidence of major adverse cardiac events, a composite of cardiac death, myocardial infarction, and target lesion revascularization. Of lesions assigned to FFR-guided strategy, only one quarter had functional significance (FFR<0.75). At 2-year follow-up, the cumulative incidence of major adverse cardiac events was 7.92.5% in the FFR-guided group and 8.82.7% in Routine-DES group (P=0.80). At 5-year follow-up, the cumulative incidence of major adverse cardiac events was 11.6 +/- 3.0% and 14.2 +/- 3.3% for the FFR-guided group and the Routine-DES group (P=0.55). There was no difference in major adverse cardiac events rates between the 2 groups 5-year follow-up (hazard ratio, 1.25; 95% confidence interval, 0.60-2.60). Conclusions In lesions with angiographically intermediate stenosis, FFR guidance provides a tailored approach, which is at least as good as an angiography-guided routine-DES implantation strategy and avoids unnecessary DES-stenting in a considerable part of the patients.
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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