• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Complete revascularization guided by fractional flow reserve not superior to angiography

byBoaz WongandHarsh Shah
August 5, 2021
in Cardiology, Chronic Disease, Imaging and Intervention
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Revascularization guided by fractional flow reserve (FFR) was shown not to have significant benefit compared to angiography for patients with ST segment-elevated myocardial infarction.

2. The wide confidence intervals for the estimate of treatment effect were unable to conclusively interpret the study’s findings.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Percutaneous coronary intervention (PCI) is a common procedure for patients experiencing ST segment-elevated myocardial infarction (STEMI). Complete vascularization of all lesions after the first successful PCI procedure has been demonstrated to reduce the risk for relapse, but the clinical difference between fractional flow reserve (FFR)-guided and angiography-guided is unknown. In a randomized control trial, patients who had received PCI for a STEMI and had multivessel disease underwent complete revascularization of non-culprit lesions either guided by FFR or angiography. The measured primary clinical outcomes were death from any cause, non-fatal myocardial infarction, or hospitalization requiring revascularization within one year. No significant differences were found between the FFR-guided and angiography-guided groups for all three of these measures. Moreover, there were no differences in all secondary outcome measures including procedure complexity, hospitalization outcomes, or improvements in patient functional status. This study’s conclusions were limited by relatively low sample size and large confidence intervals, making it difficult to draw statistically significant conclusions between the datasets. While the differences appear non-significant, further comparative studies are warranted to validate these findings.

Click to read the study in NEJM

Relevant Reading: Complete Revascularization with Multivessel PCI for Myocardial infarction

In-Depth [randomized controlled trial]: In this open-label, multicenter, randomized control trial, 1,163 patients were enrolled in the study. Patients at least 18 years of age who previously underwent PCI to resolve a STEMI and multivessel disease were included in the study. Patients with less than 50% stenosis in a major side branch at least 2.0 millimeters in diameter were excluded from the study. The patients were randomized in a 1:1 ratio to either receive complete revascularization guided by fractional flow reserve (FFR) or by angiography, respectively. The primary outcomes were death from any cause, non-fatal myocardial infarction, or hospitalization requiring revascularization within one year. Patients were followed for up to 36 months at subsequent clinical visits. The data found that there were no significant differences in any of the primary outcomes that were assessed: incidence of death from any cause (hazard ratio, [HR], 0.89; 95% confidence interval [CI], 0.36 to 2.20), non-fatal myocardial infarction (HR, 1.77; 95%CI, 0.82 to 3.84) or unplanned hospitalization requiring urgent revascularization (HR, 1.34; 95%CI, 0.62 to 2.92). The study also found no significant improvements from the FFR-guided group in secondary outcomes of future revascularization, hospitalization, or functional status. Finally, a Kaplan-Meier survival curve analysis found that both procedures had a similar ability to prevent the primary outcomes (P=0.31). The study notes that given the smaller sample size and large confidence intervals, the statistical power may not have been great enough to detect significant differences, and further studies are needed before any conclusions can be drawn. Overall, FFR-guided revascularization did not show significant benefits compared to angiography-guided revascularization.

RELATED REPORTS

#VisualAbstract: CT associated with lower complication risks than invasive coronary angiography

Coronary artery bypass grafting reduces rate of myocardial infarctions compared to percutaneous coronary intervention for left main coronary artery disease

Quantitative flow ratio-guided coronary intervention reduces the rate of major cardiac events compared to visual angiography

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: angiographyfractional flow reserve (FFRpercutaneous coronary intervention (PCI)revascularizationSTEMI
Previous Post

Insufficient evidence for using muscle relaxants to effectively relieve lower back pain

Next Post

Wellness Check: Mental Health

RelatedReports

#VisualAbstract: CT associated with lower complication risks than invasive coronary angiography
StudyGraphics

#VisualAbstract: CT associated with lower complication risks than invasive coronary angiography

June 1, 2022
Cognitive outcomes in older adults undergoing cardiovascular procedures unclear
Cardiology

Coronary artery bypass grafting reduces rate of myocardial infarctions compared to percutaneous coronary intervention for left main coronary artery disease

January 20, 2022
Drug-coated balloons are noninferior to drug-eluting stents for treatment of small vessel coronary artery disease
Cardiology

Quantitative flow ratio-guided coronary intervention reduces the rate of major cardiac events compared to visual angiography

December 21, 2021
Propofol appears safe and effective in procedural sedation for cardioversion
Cardiology

Oral P2Y12 inhibitor pretreatment offers no benefit in non-ST elevation acute coronary syndromes

May 13, 2022
Next Post
Shared decision-making tool for antidepressants improves patient and physician satisfaction

Wellness Check: Mental Health

#VisualAbstract Sporotrichosis-associated cutaneous hypersensitivity reactions occur more frequently in the fixed cutaneous form

#VisualAbstract Sporotrichosis-associated cutaneous hypersensitivity reactions occur more frequently in the fixed cutaneous form

Leadless pacemakers associated with higher rates of pericardial effusion and perforation but lower rates of other device-related complications

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Risk of post-vitrectomy endophthalmitis may have increased during the COVID-19 pandemic
  • Bosniak classification system differentiates benign renal cysts from cystic carcinoma [Classics Series]
  • Cognitive behavioral therapy efficacious for treatment of comorbid posttraumatic headache and posttraumatic stress disorder symptoms among US veterans
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.