CBS 2019
CBSMD教育中心
中 文

Acute Coronary Syndrom

Abstract

Recommended Article

Cardiovascular Risk and Statin Eligibility of Young Adults After an MI: Partners YOUNG-MI Registry Prevalence and Prognosis of Unrecognized Myocardial Infarction Determined by Cardiac Magnetic Resonance in Older Adults Age-specific gender differences in early mortality following ST-segment elevation myocardial infarction in China 1-Year Outcomes of Patients Undergoing Primary Angioplasty for Myocardial Infarction Treated With Prasugrel Versus Ticagrelor Complete Revascularization During Primary Percutaneous Coronary Intervention Reduces Death and Myocardial Infarction in Patients With Multivessel Disease-Meta-Analysis and Meta-Regression of Randomized Trials Causes of delay and associated mortality in patients transferred with ST-segment-elevation myocardial infarction The year in cardiovascular medicine 2020: acute coronary syndromes and intensive cardiac care Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes
|<<... 8 9 10 11 12 13 14 ...>>|

Original Research2019 Jan 22. pii: EIJ-D-18-00766.

JOURNAL：EuroIntervention. Article Link

Characterization of lesions undergoing ischemia-driven revascularization after complete revascularization versus culprit lesion only in patients with STEMI and multivessel disease - A DANAMI-3-PRIMULTI substudy

De Backer O, Lønborg J, Helqvist S et al. Keywords: infarct-related artery only revascularization; ischemia-driven revascularization; fractional flow reserve-guided complete revascularization

ABSTRACT

AIMS - Treatment of the infarct-related artery only (IRA-only) in ST-segment elevation myocardial infarction (STEMI) is associated with a significantly higher rate of ischemia-driven revascularization (ID-RV) during follow-up than fractional flow reserve-guided complete revascularization (FFR-CRV).

 

METHODS AND RESULTS - In this study, we characterized the lesions that underwent ID-RV in the DANAMI-3-PRIMULTI-trial (n=627) with respect to location, angiographic diameter stenosis and functional significance. Rates of admission for suspected cardiac ischemia (17%) were similar in both groups; however, ID-RV was significantly less frequent in the FFR-CRV group than in the IRA-only group (5% vs. 17%; p<0.001). In both groups, the primary reason for ID-RV were non-culprit, non-treated lesions (N=71/82 lesions in IRA-only; N=13/26 in FFR-CRV). De-novo lesions or revascularization of previously treated lesions were rarely causes of ID-RV. In the IRA-only group, there was a trend towards a higher ID-RV-rate for lesions with a higher stenosis grade and located in more proximal segments - in particular ≥80% stenosis of left anterior descending and right coronary artery also led to angina class IV/unstable angina. In the FFR-CRV group, a FFR-value ≤0.80 showed to be an appropriate threshold for revascularization.

 

CONCLUSIONS - FFR-CRV in STEMI is associated with a significantly lower rate of ID-RV at follow-up than treatment of the IRA-only - this due to a difference in non-culprit, non-treated lesions between both groups and not in de-novo lesions or repeat revascularization of previously treated lesions. Further considerations are warranted in case of high-grade non-culprit stenosis at proximal coronary segments, borderline FFR-values and/or anticipated complex PCI.

>CBS CBS 2019

> CBS 2019 REGISTRATION

> CBS 2019 PROGRAM

> CBS 2019 CALL FOR SCIENCE

> CBS 2019 SPOTLIGHTS

 CBSMD

> CBSMD WEBSITE REGISTRATION

> EDUCATION CENTER

> RECOMMANDED PAPER

> TOP 10 RESEARCH PAPER

> PRE-READING

CBS 2019 CBS 2019 FACULTY Education Resource CBSMD Scientific Library
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top