Retrospective Comparison of Long-Term Clinical Outcomes Between Percutaneous Coronary Intervention and Medical Therapy in Stable Coronary Artery Disease With Gray Zone Fractional Flow Reserveã- COMFORTABLE Retrospective Study.
Circ J
; 82(12): 3044-3051, 2018 11 24.
Article
em En
| MEDLINE
| ID: mdl-30318503
ABSTRACT
BACKGROUND:
A fractional flow reserve (FFR) between 0.75 and 0.80 constitutes a "gray zone" for clinical decision-making in coronary artery disease. We compared long-term outcomes of percutaneous coronary intervention (PCI) using drug-eluting stents vs. medical therapy for coronary stenosis with gray zone FFR. MethodsâandâResults:
We retrospectively investigated the clinical outcomes of 263 patients with gray zone FFR 78 patients in the PCI group and 185 patients in the medical therapy group. During a median follow-up of 3.7 years, the frequency of target vessel failure (TVF, defined as a composite of cardiac death, myocardial infarction [MI], or ischemia-driven target vessel revascularization [TVR]) was significantly lower in the PCI group compared with the medical therapy group (6% vs. 19%, hazard ratio [HR]0.33, 95% confidence interval [CI] 0.13-0.84, P=0.008). The frequency of a composite of cardiac death or MI was not different between the 2 groups (1% vs. 2%, HR 0.61, 95% CI 0.07-5.49, P=0.645). The frequency of ischemia-driven TVR was significantly lower in the PCI group compared with the medical therapy group (5% vs. 18%, HR 0.28, 95% CI 0.10-0.79, P=0.005).CONCLUSIONS:
In patients with gray zone FFR, compared with medical therapy, PCI decreased the frequency of TVF, which was mainly driven by a reduction in the frequency of angina or myocardial ischemia without any difference in the frequency of cardiac death or MI.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
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Estenose Coronária
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Reserva Fracionada de Fluxo Miocárdico
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Intervenção Coronária Percutânea
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Infarto do Miocárdio
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Circ J
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article