Angiographic Versus Functional Severity of Coronary Artery Stenoses in the FAME Study Fractional Flow Reserve Versus Angiography in Multivessel Evaluation
Angiographic Versus Functional Severity of Coronary Artery Stenoses in the FAME Study Fractional Flow Reserve Versus Angiography in Multivessel Evaluation
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DOI：
10.1016/j.jacc.2009.11.096
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发表时间：
2010-06-22
影响因子：
24
通讯作者：
Pijls, Nico H. J.
中科院分区：
文献类型：
--
作者：
Tonino, Pim A. L.;Fearon, William F.;Pijls, Nico H. J.
目的本研究的目的是探讨FAME研究中冠状动脉狭窄的血管造影和功能严重程度之间的关系（血流储备分数与血管造影在多支血管评价中的比较）。诱导缺血的冠状动脉狭窄的血运重建改善了患者的功能状态和结果。对于不引起缺血的狭窄，然而，血运重建的好处是不太清楚。方法在FAME研究中，常规测量血流储备分数（FFR）进行了比较，血管造影术指导多支冠状动脉疾病患者的经皮冠状动脉介入治疗。除血管造影术外，FFR的使用显著降低了1年时所有主要不良心脏事件的发生率。在1,414处病变中，在FAME研究的FFR引导组中，有1，329例患者成功通过FFR进行了评估，并纳入本分析。（所有病变的47%）、71%-90%（所有病变的39%）和91%-99%（所有病变的15%）直径狭窄。在50%-70%狭窄类别中，35%具有功能显著性（FFR 0.80）。在71%至90%狭窄的类别中，80%具有功能显著性，20%不具有功能显著性。在次全狭窄类别中，96%具有功能显著性。在所有509例血管造影定义的多支血管病变患者中，仅235例（46%）有功能性多支血管病变（FFR ≥ 2支冠状动脉
Objectives The purpose of this study was to investigate the relationship between angiographic and functional severity of coronary artery stenoses in the FAME (Fractional Flow Reserve Versus Angiography in Multivessel Evaluation) study.Background It can be difficult to determine on the coronary angiogram which lesions cause ischemia. Revascularization of coronary stenoses that induce ischemia improves a patient's functional status and outcome. For stenoses that do not induce ischemia, however, the benefit of revascularization is less clear.Methods In the FAME study, routine measurement of the fractional flow reserve (FFR) was compared with angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease. The use of the FFR in addition to angiography significantly reduced the rate of all major adverse cardiac events at 1 year. Of the 1,414 lesions (509 patients) in the FFR-guided arm of the FAME study, 1,329 were successfully assessed by the FFR and are included in this analysis.Results Before FFR measurement, these lesions were categorized into 50% to 70% (47% of all lesions), 71% to 90% (39% of all lesions), and 91% to 99% (15% of all lesions) diameter stenosis by visual assessment. In the category 50% to 70% stenosis, 35% were functionally significant (FFR 0.80). In the category 71% to 90% stenosis, 80% were functionally significant and 20% were not. In the category of subtotal stenoses, 96% were functionally significant. Of all 509 patients with angiographically defined multivessel disease, only 235 (46%) had functional multivessel disease (>= 2 coronary arteries with an FFR