CBS 2019
CBSMD教育中心
中 文

急性冠脉综合征

Abstract

Recommended Article

Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association Association of the PHACTR1/EDN1 Genetic Locus With Spontaneous Coronary Artery Dissection Cardiovascular Mortality After Type 1 and Type 2 Myocardial Infarction in Young Adults Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction Use of Mechanical Circulatory Support Devices Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock Refractory Angina: From Pathophysiology to New Therapeutic Nonpharmacological Technologies Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995-2014 Early Natural History of Spontaneous Coronary Artery Dissection
|<<... 21 22 23 24 25 26 27 ...>>|

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