Completeness of revascularization by FFRCT in stable angina: Association to adverse cardiovascular outcomes.
J Cardiovasc Comput Tomogr
; 2024 Jul 17.
Article
em En
| MEDLINE
| ID: mdl-39025756
ABSTRACT
BACKGROUND:
The prognostic impact of complete coronary revascularization relative to non-invasive testing methods is unknown.OBJECTIVES:
To assess the association between completeness of revascularization defined by CTA-derived fractional flow reserve (FFRCT) and cardiovascular outcomes in patients with stable angina.METHODS:
Multicenter 3-year follow-up study of patients with new onset stable angina and ≥ 30% stenosis by CTA. The lesion-specific FFRCT value (two cm-distal-to-stenosis) was registered in all vessels with stenosis and considered abnormal when ≤ 0.80. Patients with FFRCT ≤ 0.80 were categorized as Completely revascularized (CR-FFRCT), all vessels with FFRCT ≤ 0.80 revascularized; incompletely revascularized (IR-FFRCT), ≥ 1 vessels with FFRCT ≤ 0.80 non-revascularized. Early revascularization (< 90 days from index CTA) categorized vessels as revascularized. The primary endpoint comprised cardiovascular death and non-fatal myocardial infarction; the secondary endpoint vessel-specific late revascularization and non-fatal myocardial infarction.RESULTS:
Amongst 900 patients and 1759 vessels, FFRCT was ≤ 0.80 in 377 (42%) patients, 536 (30%) vessels; revascularization was performed in 244 (27%) patients, 340 (19%) vessels. Risk of the primary endpoint was higher for IR-FFRCT (15/210 [7.1%]) compared to CR-FFRCT (4/167 [2.4%]), RR 2.98; 95% CI 1.01-8.8, p â= â0.036, and to normal FFRCT (3/523 [0.6%]), RR 12.45; 95% CI 3.6-42.6, p â< â0.001. Incidence of the secondary endpoint was higher in non-revascularized vessels with FFRCT ≤ 0.80 (29/250 [12%]) compared to revascularized vessels with FFRCT ≤ 0.80 (5/286 [1.7%]), p â= â0.001, and to vessels with FFRCT > 0.80 (10/1223 [0.8%]), p â< â0.001.CONCLUSION:
Incomplete revascularization of patients with lesion-specific FFRCT ≤ 0.80 is associated to unfavorable cardiovascular outcomes compared to those with complete revascularization or FFRCT > 0.80.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
J Cardiovasc Comput Tomogr
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article