Long-Term Outcome After Deferral of Revascularization in Patients With Intermediate Coronary Stenosis and Gray-Zone Fractional Flow Reserve

• Shiono Yasutsugu

  Department of Cardiovascular Medicine, Wakayama Medical University

• Kubo Takashi

  Department of Cardiovascular Medicine, Wakayama Medical University

• Tanaka Atsushi

  Department of Cardiovascular Medicine, Wakayama Medical University

• Ino Yasushi

  Department of Cardiovascular Medicine, Wakayama Medical University

• Yamaguchi Tomoyuki

  Department of Cardiovascular Medicine, Wakayama Medical University

• Tanimoto Takashi

  Department of Cardiovascular Medicine, Wakayama Medical University

• Yamano Takashi

  Department of Cardiovascular Medicine, Wakayama Medical University

• Matsuo Yoshiki

  Department of Cardiovascular Medicine, Wakayama Medical University

• Nishiguchi Tsuyoshi

  Department of Cardiovascular Medicine, Wakayama Medical University

• Teraguchi Ikuko

  Department of Cardiovascular Medicine, Wakayama Medical University

• Ota Shingo

  Department of Cardiovascular Medicine, Wakayama Medical University

• Ozaki Yuichi

  Department of Cardiovascular Medicine, Wakayama Medical University

• Orii Makoto

  Department of Cardiovascular Medicine, Wakayama Medical University

• Shimamura Kunihiro

  Department of Cardiovascular Medicine, Wakayama Medical University

• Kitabata Hironori

  Department of Cardiovascular Medicine, Wakayama Medical University

• Hirata Kumiko

  Department of Cardiovascular Medicine, Wakayama Medical University

• Imanishi Toshio

  Department of Cardiovascular Medicine, Wakayama Medical University

• Akasaka Takashi

  Department of Cardiovascular Medicine, Wakayama Medical University

抄録

Background:A strategy of deferred percutaneous coronary intervention for coronary stenosis with fractional flow reserve (FFR) 0.75–0.80, termed the gray zone, remains a matter of debate. The aim of this study was to assess the safety of deferring revascularization for patients with FFR 0.75–0.80 compared with those with FFR >0.80.Methods and Results:We assessed 3-year clinical outcome in 150 patients with angiographically intermediate stenosis who had revascularization deferred on the basis of FFR ≥0.75 (FFR 0.75–0.80, n=56; FFR >0.80, n=94). Target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction (MI), and ischemia-driven target vessel revascularization (TVR) was evaluated during follow-up. Cardiac death was observed in 1 patient with FFR 0.75–0.80. There was no target vessel-related MI in either group. The incidence of ischemia-driven TVR was higher in patients with FFR 0.75–0.80 than in those with FFR >0.80 (14% vs. 3%, P=0.020). TVF-free survival was significantly worse for the patients with FFR 0.75–0.80 than those with FFR >0.80 (hazard ratio, 5.2; 95% confidence intervals: 1.4–19.5; P=0.015).Conclusions:Patients with FFR 0.75–0.80 were at higher risk of TVF mainly due to TVR than those with FFR >0.80. (Circ J 2015; 79: 91–95)

収録刊行物

• Circulation Journal

  Circulation Journal 79 (1), 91-95, 2014

  一般社団法人 日本循環器学会

キーワード

• Deferred revascularization
• Fractional flow reserve
• Gray zone
• Intermediate coronary stenosis

詳細情報

• CRID: 1390282680083629056
• NII論文ID: 130004704027
• NII論文ID: 40020311804
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-14-0671
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 026000847
• PubMed: 25410812
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I026000847
• Web Site: https://www.jstage.jst.go.jp/article/circj/79/1/79_CJ-14-0671/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2015294776
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
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