Fractional Flow Reserve Versus Angiography for Guiding Percutaneous Coronary Intervention in Patients With Multivessel Coronary Artery Disease 2-Year Follow-Up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) Study
Fractional Flow Reserve Versus Angiography for Guiding Percutaneous Coronary Intervention in Patients With Multivessel Coronary Artery Disease 2-Year Follow-Up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) Study
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DOI：
10.1016/j.jacc.2010.04.012
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发表时间：
2010-07-13
影响因子：
24
通讯作者：
De Bruyne, Bernard
中科院分区：
文献类型：
--
作者：
Pijls, Nico H. J.;Fearon, William F.;De Bruyne, Bernard
目的探讨血流储备分数（fractional flow reserve，FFR）指导下经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）治疗多支冠状动脉疾病（multiple vessel coronary artery disease，CAD）的2年疗效。FAME（血流储备分数与血管造影术评价多支血管）研究表明，除血管造影术外，常规FFR可改善1年时PCI的结局。这是未知的，如果这些有利的结果是保持在2年的follow-up.Methods在20个美国和欧洲的医疗中心，1,005例多支血管CAD患者被随机分配到PCI与药物洗脱支架引导血管造影单独或引导血流储备分数测量。在随机化之前，根据血管造影表现确定需要PCI的病变。随机接受血管造影引导PCI的患者接受了所有指定病变的支架植入术，而随机接受FFR引导PCI的患者仅在FFR <0.80时接受指定病变的支架植入术，2年后心肌梗死发生率为0.2%，血运重建率为3.2%。与标准血管造影引导PCI相比，洗脱支架显著降低了2年时的死亡率和心肌梗死。（血流储备分数与血管造影术用于多支血管评价[FAME]; NCT 00267774）（J Am科尔心脏病学杂志2010; 56：177-84）（C）美国心脏病学会基金会2010年
Objectives The purpose of this study was to investigate the 2-year outcome of percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) in patients with multivessel coronary artery disease (CAD).Background In patients with multivessel CAD undergoing PCI, coronary angiography is the standard method for guiding stent placement. The FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study showed that routine FFR in addition to angiography improves outcomes of PCI at 1 year. It is unknown if these favorable results are maintained at 2 years of follow-up.Methods At 20 U.S. and European medical centers, 1,005 patients with multivessel CAD were randomly assigned to PCI with drug-eluting stents guided by angiography alone or guided by FFR measurements. Before randomization, lesions requiring PCI were identified based on their angiographic appearance. Patients randomized to angiography-guided PCI underwent stenting of all indicated lesions, whereas those randomized to FFR-guided PCI underwent stenting of indicated lesions only if the FFR was 0.80, the rate of myocardial infarction was 0.2 % and the rate of revascularization was 3.2 % after 2 years.Conclusions Routine measurement of FFR in patients with multivessel CAD undergoing PCI with drug-eluting stents significantly reduces mortality and myocardial infarction at 2 years when compared with standard angiography-guided PCI. (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation [FAME]; NCT00267774) (J Am Coll Cardiol 2010; 56: 177-84) (C) 2010 by the American College of Cardiology Foundation