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Fournier, S; Toth, GG; De Bruyne, B; Johnson, NP; Ciccarelli, G; Xaplanteris, P; Milkas, A; Strisciuglio, T; Bartunek, J; Vanderheyden, M; Wyffels, E; Casselman, F; Van Praet, F; Stockman, B; Degrieck, I; Barbato, E.
Six-Year Follow-Up of Fractional Flow Reserve-Guided Versus Angiography-Guided Coronary Artery Bypass Graft Surgery.
Circ Cardiovasc Interv. 2018; 11(6):e006368-e006368 Doi: 10.1161/CIRCINTERVENTIONS.117.006368 [OPEN ACCESS]
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Toth-Gayor Gabor

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Fractional flow reserve (FFR)-guided coronary artery bypass graft (CABG) surgery has been associated with lower number of graft anastomoses, lower rate of on-pump surgery, and higher graft patency rate as compared with angiography-guided CABG surgery. However, no clinical benefit has been reported to date. Consecutive patients (n=627) treated by CABG between 2006 and 2010 were retrospectively included. In 198 patients, at least 1 stenosis was grafted according to FFR (FFR-guided group), whereas in 429 patients all stenoses were grafted based on angiography (angiography-guided group). The 2 coprimary end points were overall death or myocardial infarction and major adverse cardiovascular events (composite of overall death, myocardial infarction, and target vessel revascularization) up to 6-year follow-up. In the FFR-guided group, patients were significantly younger (66 [57-73] versus 70 [63-76]; P<0.001), more often male (82% versus 72%; P=0.008), and less often diabetic (21% versus 30%; P=0.023). Clinical follow-up (median, 85 [66-104] months) was analyzed in 396 patients after 1:1 propensity-score matching for these 3 variables. The rate of overall death or myocardial infarction was significantly lower in the FFR-guided (n=31 [16%] versus n=49 [25%]; hazard ratio, 0.59 [95% confidence interval, 0.38-0.93]; P=0.020) as compared with the angiography-guided group. Major adverse cardiovascular events rate was also numerically lower in the FFR-guided than in the angiography-guided group (n=42 [21%] versus n=52 [26%]; hazard ratio, 0.77 [95% confidence interval, 0.51-1.16]; P=0.21). FFR-guided CABG is associated with a significant reduction in the rate of overall death or myocardial infarction at 6-year follow-up as compared with angiography-guided CABG. © 2018 American Heart Association, Inc.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Cardiac Catheterization -
Coronary Angiography -
Coronary Artery Bypass - adverse effects
Coronary Artery Bypass - mortality
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - mortality
Coronary Artery Disease - physiopathology
Coronary Artery Disease - surgery
Coronary Stenosis - diagnostic imaging
Coronary Stenosis - mortality
Coronary Stenosis - physiopathology
Coronary Stenosis - surgery
Coronary Vessels - diagnostic imaging
Coronary Vessels - physiopathology
Coronary Vessels - surgery
Female -
Fractional Flow Reserve, Myocardial -
Graft Occlusion, Vascular - etiology
Graft Occlusion, Vascular - physiopathology
Humans -
Male -
Middle Aged -
Myocardial Infarction - etiology
Myocardial Infarction - physiopathology
Predictive Value of Tests -
Retrospective Studies -
Risk Assessment -
Risk Factors -
Time Factors -
Treatment Outcome -
Vascular Patency -

Find related publications in this database (Keywords)
coronary artery bypass
coronary artery disease
coronary stenosis
fractional flow reserve
myocardial infarction
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