المؤلفون: Demandt, Jesse P A, Zelis, Jo M, Koks, Arjan, Smits, Geert H J M, van der Harst, Pim, Tonino, Pim A L, Dekker, Lukas R C, van Het Veer, Marcel, Vlaar, Pieter-Jan

المساهمون: Team Medisch, Circulatory Health

مصطلحات موضوعية: Acute Coronary Syndrome/diagnosis, Electrocardiography/methods, Emergency Medical Services/methods, Humans, Prospective Studies, Risk Assessment/methods, myocardial infarction, primary care, coronary heart disease, cardiology, General Medicine, Research Support, Non-U.S. Gov't, Meta-Analysis, Journal Article

الوصف: OBJECTIVE: To review, inventory and compare available diagnostic tools and investigate which tool has the best performance for prehospital risk assessment in patients suspected of non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: Systematic review and meta-analysis. Medline and Embase were searched up till 1 April 2021. Prospective studies with patients, suspected of NSTE-ACS, presenting in the primary care setting or by emergency medical services (EMS) were included. The most important exclusion criteria were studies including only patients with ST-elevation myocardial infarction and studies before 1995, the pretroponin era. The primary end point was the final hospital discharge diagnosis of NSTE-ACS or major adverse cardiac events (MACE) within 6 weeks. Risk of bias was evaluated by the Quality Assessment of Diagnostic Accuracy Studies Criteria. MAIN OUTCOME AND MEASURES: Sensitivity, specificity and likelihood ratio of findings for risk stratification in patients suspected of NSTE-ACS. RESULTS: In total, 15 prospective studies were included; these studies reflected in total 26 083 patients. No specific variables related to symptoms, physical examination or risk factors were useful in risk stratification for NSTE-ACS diagnosis. The most useful electrocardiographic finding was ST-segment depression (LR+3.85 (95% CI 2.58 to 5.76)). Point-of-care troponin was found to be a strong predictor for NSTE-ACS in primary care (LR+14.16 (95% CI 4.28 to 46.90) and EMS setting (LR+6.16 (95% CI 5.02 to 7.57)). Combined risk scores were the best for risk assessment in an NSTE-ACS. From the combined risk scores that can be used immediately in a prehospital setting, the PreHEART score, a validated combined risk score for prehospital use, derived from the HEART score (History, ECG, Age, Risk factors, Troponin), was most useful for risk stratification in patients with NSTE-ACS (LR+8.19 (95% CI 5.47 to 12.26)) and for identifying patients without ACS (LR-0.05 (95% CI 0.02 to 0.15)). DISCUSSION: Important study ...

وصف الملف: application/pdf

العلاقة: https://dspace.library.uu.nl/handle/1874/446402Test

الإتاحة: https://dspace.library.uu.nl/handle/1874/446402Test

المؤلفون: Smits, Pieter C, Frigoli, Enrico, Tijssen, Jan, Jüni, Peter, Vranckx, Pascal, Ozaki, Yukio, Morice, Marie-Claude, Chevalier, Bernard, Onuma, Yoshinobu, Windecker, Stephan, Tonino, Pim A L, Roffi, Marco, Lesiak, Maciej, Mahfoud, Felix, Bartunek, Jozef, Hildick-Smith, David, Colombo, Antonio, Stankovic, Goran, Iñiguez, Andrés, Schultz, Carl, Kornowski, Ran, Ong, Paul J L, Alasnag, Mirvat, Rodriguez, Alfredo E, Moschovitis, Aris, Laanmets, Peep, Heg, Dik, Valgimigli, Marco, MASTER DAPT Investigators

المصدر: ISSN: 0009-7322 ; Circulation, vol. 144, no. 15 (2021) p. 1196-1211.

مصطلحات موضوعية: info:eu-repo/classification/ddc/616, Antiplatelet therapy, Dual antiplatelet therapy, Percutaneous coronary intervention, Administration, Oral, Aged, Anticoagulants / pharmacology, Anticoagulants / therapeutic use, Female, Hemorrhage / drug therapy, Humans, Male, Platelet Aggregation Inhibitors / pharmacology, Platelet Aggregation Inhibitors / therapeutic use, Risk Factors, Stents / standards

الوصف: Background: The optimal duration of antiplatelet therapy (APT) in patients at high bleeding risk with or without oral anticoagulation (OAC) after coronary stenting remains unclear. Methods: In the investigator-initiated, randomize, open-label MASTER DAPT trial (Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Standard DAPT Regimen), 4579 patients at high bleeding risk were randomized after 1-month dual APT to abbreviated or nonabbreviated APT strategies. Randomization was stratified by concomitant OAC indication. In this subgroup analysis, we report outcomes of populations with or without an OAC indication. In the population with an OAC indication, patients changed immediately to single APT for 5 months (abbreviated regimen) or continued ≥2 months of dual APT and single APT thereafter (nonabbreviated regimen). Patients without an OAC indication changed to single APT for 11 months (abbreviated regimen) or continued ≥5 months of dual APT and single APT thereafter (nonabbreviated regimen). Coprimary outcomes at 335 days after randomization were net adverse clinical outcomes (composite of all-cause death, myocardial infarction, stroke, and Bleeding Academic Research Consortium 3 or 5 bleeding events); major adverse cardiac and cerebral events (all-cause death, myocardial infarction, and stroke); and type 2, 3, or 5 Bleeding Academic Research Consortium bleeding. Results: Net adverse clinical outcomes or major adverse cardiac and cerebral events did not differ with abbreviated versus nonabbreviated APT regimens in patients with OAC indication (n=1666; hazard ratio [HR], 0.83 [95% CI, 0.60-1.15]; and HR, 0.88 [95% CI, 0.60-1.30], respectively) or without OAC indication (n=2913; HR, 1.01 [95% CI, 0.77-1.33]; or HR, 1.06 [95% CI, 0.79-1.44]; Pinteraction=0.35 and 0.45, respectively). Bleeding Academic Research Consortium 2, 3, or 5 bleeding did not significantly differ in patients with OAC indication (HR, 0.83 [95% CI, 0.62-1.12]) but was lower ...

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34455849; https://archive-ouverte.unige.ch/unige:161105Test; unige:161105

الإتاحة: https://doi.org/10.1161/CIRCULATIONAHA.121.056680Test
https://archive-ouverte.unige.ch/unige:161105Test

المؤلفون: Doolub, Gemina, Tonino, Pim A L, Kedev, Sasko, Monségu, Jacques, Paradies, Valeria, Austin, David, Spanó, Fabrizio, Roffi, Marco, Fröbert, Ole, von Birgelen, Clemens, Buchanan, Louise, Mamas, Mamas A, e-ULTIMASTER investigators

المصدر: ISSN: 0002-9149 ; The American journal of cardiology, vol. 186 (2023) p. 71-79.

مصطلحات موضوعية: info:eu-repo/classification/ddc/616, Humans, Female, Male, Percutaneous Coronary Intervention / adverse effects, Coronary Artery Disease / therapy, Prospective Studies, Risk Factors, Treatment Outcome, Angioplasty, Balloon, Coronary / adverse effects, Death

الوصف: Female gender has been shown to be associated with worse clinical outcomes after percutaneous coronary intervention (PCI). However, the impact of gender on the clinical outcomes of complex PCI is still poorly understood. This study examined the differences in patient and coronary lesion characteristics and longer-term clinical outcomes in male and female patients who underwent complex PCI. This was a sub-analysis of the e-ULTIMASTER study, which was a large, multicontinental, prospective, observational study enrolling 37,198 patients who underwent PCI with the Ultimaster stent. Patients who underwent complex PCI were stratified by gender. The primary outcome was target lesion failure at 12 months, defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 12 months. A total of 13,623 patients underwent complex procedures, of which 35.7% were women. Women were twice as likely as men to be aged ≥80 years (17.6% vs 9%, p <0.0001) and had a higher prevalence of cardiovascular risk factors. Women had fewer lesions treated than men (1.5 ± 0.8 vs 1.6 ± 0.8, p <0.0001) and fewer stents implanted (2.0 ± 1.1 vs 2.1 ± 1.1, p <0.0001). There was no statistically significant difference in clinical outcomes at 12 months between women and men. Event rates were comparable in women and men for target lesion failure (4.7% vs 4.3%, p = 0.30), target vessel failure (5.1% vs 4.9%, p = 0.73), and cardiac death (1.8% vs 1.7%, p = 0.80).In conclusion, our findings suggest no significant differences in clinical outcomes between women and men who underwent complex PCI.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/36368145; https://archive-ouverte.unige.ch/unige:175239Test; unige:175239

الإتاحة: https://doi.org/10.1016/j.amjcard.2022.10.023Test
https://archive-ouverte.unige.ch/unige:175239Test

المؤلفون: Zimmermann, Frederik M, Ding, Victoria Y, Pijls, Nico H J, Piroth, Zsolt, van Straten, Albert H M, Szekely, Laszlo, Davidavicius, Giedrius, Kalinauskas, Gintaras, Mansour, Samer, Kharbanda, Rajesh, Östlund-Papadogeorgos, Nikolaos, Aminian, Adel, Oldroyd, Keith G, Al-Attar, Nawwar, Jagic, Nikola, Dambrink, Jan-Henk E, Kala, Petr, Angeras, Oskar, MacCarthy, Philip, Wendler, Olaf, Casselman, Filip, Witt, Nils, Mavromatis, Kreton, Miner, Steven E S, Sarma, Jaydeep, Engstrøm, Thomas, Christiansen, Evald H, Tonino, Pim A L, Reardon, Michael J, Otsuki, Hisao, Kobayashi, Yuhei, Hlatky, Mark A, Mahaffey, Kenneth W, Desai, Manisha, Woo, Y Joseph, Yeung, Alan C, De Bruyne, Bernard, Fearon, William F

المصدر: Zimmermann , F M , Ding , V Y , Pijls , N H J , Piroth , Z , van Straten , A H M , Szekely , L , Davidavicius , G , Kalinauskas , G , Mansour , S , Kharbanda , R , Östlund-Papadogeorgos , N , Aminian , A , Oldroyd , K G , Al-Attar , N , Jagic , N , Dambrink , J-H E , Kala , P , Angeras , O , MacCarthy , P , Wendler , O , Casselman , F , Witt , N , Mavromatis , ....

مصطلحات موضوعية: coronary artery bypass, drug-eluting stents, percutaneous coronary intervention, Percutaneous Coronary Intervention/adverse effects, Myocardial Infarction, Fractional Flow Reserve, Myocardial, Follow-Up Studies, Humans, Stroke/epidemiology, Coronary Artery Bypass/adverse effects, Coronary Artery Disease/surgery

الوصف: BACKGROUND: Previous studies comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with multivessel coronary disease not involving the left main have shown significantly lower rates of death, myocardial infarction (MI), or stroke after CABG. These studies did not routinely use current-generation drug-eluting stents or fractional flow reserve (FFR) to guide PCI. METHODS: FAME 3 (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) is an investigator-initiated, multicenter, international, randomized trial involving patients with 3-vessel coronary artery disease (not involving the left main coronary artery) in 48 centers worldwide. Patients were randomly assigned to receive FFR-guided PCI using zotarolimus drug-eluting stents or CABG. The prespecified key secondary end point of the trial reported here is the 3-year incidence of the composite of death, MI, or stroke. RESULTS: A total of 1500 patients were randomized to FFR-guided PCI or CABG. Follow-up was achieved in >96% of patients in both groups. There was no difference in the incidence of the composite of death, MI, or stroke after FFR-guided PCI compared with CABG (12.0% versus 9.2%; hazard ratio [HR], 1.3 [95% CI, 0.98-1.83]; P=0.07). The rates of death (4.1% versus 3.9%; HR, 1.0 [95% CI, 0.6-1.7]; P=0.88) and stroke (1.6% versus 2.0%; HR, 0.8 [95% CI, 0.4-1.7]; P=0.56) were not different. MI occurred more frequently after PCI (7.0% versus 4.2%; HR, 1.7 [95% CI, 1.1-2.7]; P=0.02). CONCLUSIONS: At 3-year follow-up, there was no difference in the incidence of the composite of death, MI, or stroke after FFR-guided PCI with current-generation drug-eluting stents compared with CABG. There was a higher incidence of MI after PCI compared with CABG, with no difference in death or stroke. These results provide contemporary data to allow improved shared decision-making between physicians and patients with 3-vessel coronary artery disease. REGISTRATION: URL: https://wwwTest. CLINICALTRIALS: gov; ...

العلاقة: https://pure.au.dk/portal/en/publications/9d06ad91-44e3-42ea-8276-50bca758019eTest

الإتاحة: https://doi.org/10.1161/CIRCULATIONAHA.123.065770Test
https://pure.au.dk/portal/en/publications/9d06ad91-44e3-42ea-8276-50bca758019eTest
http://www.scopus.com/inward/record.url?scp=85171806560&partnerID=8YFLogxKTest

المؤلفون: Valgimigli, Marco, Frigoli, Enrico, Heg, Dik, Tijssen, Jan, Jüni, Peter, Vranckx, Pascal, Ozaki, Yukio, Morice, Marie-Claude, Chevalier, Bernard, Onuma, Yoshinobu, Windecker, Stephan, Tonino, Pim A L, Roffi, Marco, Lesiak, Maciej, Mahfoud, Felix, Bartunek, Jozef, Hildick-Smith, David, Colombo, Antonio, Stanković, Goran, Iñiguez, Andrés, Schultz, Carl, Kornowski, Ran, Ong, Paul J L, Alasnag, Mirvat, Rodriguez, Alfredo E, Moschovitis, Aris, Laanmets, Peep, Donahue, Michael, Leonardi, Sergio, Smits, Pieter C, MASTER DAPT Investigators

المصدر: ISSN: 0028-4793 ; The New England journal of medicine, vol. 385, no. 18 (2021) p. 1643-1655.

مصطلحات موضوعية: info:eu-repo/classification/ddc/616, Acute Coronary Syndrome / complications, Acute Coronary Syndrome / mortality, Acute Coronary Syndrome / therapy, Aged, Cardiovascular Diseases / mortality, Drug Therapy, Combination, Drug-Eluting Stents, Female, Hemorrhage / chemically induced, Humans, Kaplan-Meier Estimate, Male, Myocardial Infarction / etiology, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors / administration & dosage, Platelet Aggregation Inhibitors / adverse effects, Platelet Aggregation Inhibitors / therapeutic use, Risk Factors, Stroke / etiology, Thrombosis / prevention & control

الوصف: Background: The appropriate duration of dual antiplatelet therapy in patients at high risk for bleeding after the implantation of a drug-eluting coronary stent remains unclear. Methods: One month after they had undergone implantation of a biodegradable-polymer sirolimus-eluting coronary stent, we randomly assigned patients at high bleeding risk to discontinue dual antiplatelet therapy immediately (abbreviated therapy) or to continue it for at least 2 additional months (standard therapy). The three ranked primary outcomes were net adverse clinical events (a composite of death from any cause, myocardial infarction, stroke, or major bleeding), major adverse cardiac or cerebral events (a composite of death from any cause, myocardial infarction, or stroke), and major or clinically relevant nonmajor bleeding; cumulative incidences were assessed at 335 days. The first two outcomes were assessed for noninferiority in the per-protocol population, and the third outcome for superiority in the intention-to-treat population. Results: Among the 4434 patients in the per-protocol population, net adverse clinical events occurred in 165 patients (7.5%) in the abbreviated-therapy group and in 172 (7.7%) in the standard-therapy group (difference,-0.23 percentage points; 95% confidence interval [CI],-1.80 to 1.33; P<0.001 for noninferiority). A total of 133 patients (6.1%) in the abbreviated-therapy group and 132 patients (5.9%) in the standard-therapy group had a major adverse cardiac or cerebral event (difference, 0.11 percentage points; 95% CI,-1.29 to 1.51; P = 0.001 for noninferiority). Among the 4579 patients in the intention-to-treat population, major or clinically relevant nonmajor bleeding occurred in 148 patients (6.5%) in the abbreviated-therapy group and in 211 (9.4%) in the standard-therapy group (difference,-2.82 percentage points; 95% CI,-4.40 to-1.24; P<0.001 for superiority). Conclusions: One month of dual antiplatelet therapy was noninferior to the continuation of therapy for at least 2 additional months with ...

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34449185; https://archive-ouverte.unige.ch/unige:161611Test; unige:161611

الإتاحة: https://doi.org/10.1056/NEJMoa2108749Test
https://archive-ouverte.unige.ch/unige:161611Test

المؤلفون: Xaplanteris, Panagiotis, Fournier, Stephane, Pijls, Nico H J, Fearon, William F, Barbato, Emanuele, Tonino, Pim A L, Engstrøm, Thomas, Kääb, Stefan, Dambrink, Jan-Henk, Rioufol, Gilles, Toth, Gabor G, Piroth, Zsolt, Witt, Nils, Fröbert, Ole, Kala, Petr, Linke, Axel, Jagic, Nicola, Mates, Martin, Mavromatis, Kreton, Samady, Habib, Irimpen, Anand, Oldroyd, Keith, Campo, Gianluca, Rothenbühler, Martina, Jüni, Peter, De Bruyne, Bernard

المصدر: Xaplanteris , P , Fournier , S , Pijls , N H J , Fearon , W F , Barbato , E , Tonino , P A L , Engstrøm , T , Kääb , S , Dambrink , J-H , Rioufol , G , Toth , G G , Piroth , Z , Witt , N , Fröbert , O , Kala , P , Linke , A , Jagic , N , Mates , M , Mavromatis , K , Samady , H , Irimpen , A , Oldroyd , K , Campo , G , Rothenbühler ....

مصطلحات موضوعية: Aged, Angina Pectoris/therapy, Antihypertensive Agents/therapeutic use, Coronary Disease/drug therapy, Coronary Stenosis/drug therapy, Drug-Eluting Stents, Female, Follow-Up Studies, Fractional Flow Reserve, Myocardial, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction/epidemiology, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors/therapeutic use, Retreatment/statistics & numerical data

الوصف: BACKGROUND: We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. METHODS: Among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy and were entered into a registry. The primary end point was a composite of death, myocardial infarction, or urgent revascularization. RESULTS: A total of 888 patients underwent randomization (447 patients in the PCI group and 441 in the medical-therapy group). At 5 years, the rate of the primary end point was lower in the PCI group than in the medical-therapy group (13.9% vs. 27.0%; hazard ratio, 0.46; 95% confidence interval [CI], 0.34 to 0.63; P<0.001). The difference was driven by urgent revascularizations, which occurred in 6.3% of the patients in the PCI group as compared with 21.1% of those in the medical-therapy group (hazard ratio, 0.27; 95% CI, 0.18 to 0.41). There were no significant differences between the PCI group and the medical-therapy group in the rates of death (5.1% and 5.2%, respectively; hazard ratio, 0.98; 95% CI, 0.55 to 1.75) or myocardial infarction (8.1% and 12.0%; hazard ratio, 0.66; 95% CI, 0.43 to 1.00). There was no significant difference in the rate of the primary end point between the PCI group and the registry cohort (13.9% and 15.7%, respectively; hazard ratio, 0.88; 95% CI, 0.55 to 1.39). Relief from angina was more pronounced after PCI than after medical therapy. CONCLUSIONS: In patients with stable coronary artery disease, an initial FFR-guided PCI strategy was associated with a significantly lower rate of the primary composite end point of death, myocardial infarction, or urgent revascularization at 5 years than medical therapy alone. ...

الإتاحة: https://doi.org/10.1056/NEJMoa1803538Test
https://curis.ku.dk/portal/da/publications/fiveyear-outcomes-with-pci-guided-by-fractional-flow-reserveTest(d4123166-0c75-4e7b-93d5-f88b8756849f).html

المؤلفون: Johnson, Nils P, Tóth, Gábor G, Lai, Dejian, Zhu, Hongjian, Açar, Göksel, Agostoni, Pierfrancesco, Appelman, Yolande, Arslan, Fatih, Barbato, Emanuele, Chen, Shao-Liang, Di Serafino, Luigi, Domínguez-Franco, Antonio J, Dupouy, Patrick, Esen, Ali M, Esen, Ozlem B, Hamilos, Michalis, Iwasaki, Kohichiro, Jensen, Lisette O, Jiménez-Navarro, Manuel F, Katritsis, Demosthenes G, Kocaman, Sinan A, Koo, Bon-Kwon, López-Palop, Ramón, Lorin, Jeffrey D, Miller, Louis H, Muller, Olivier, Nam, Chang-Wook, Oud, Niels, Puymirat, Etienne, Rieber, Johannes, Rioufol, Gilles, Rodés-Cabau, Josep, Sedlis, Steven P, Takeishi, Yasuchika, Tonino, Pim A L, Van Belle, Eric, Verna, Edoardo, Werner, Gerald S, Fearon, William F, Pijls, Nico H J, De Bruyne, Bernard, Gould, K Lance

المصدر: Johnson , N P , Tóth , G G , Lai , D , Zhu , H , Açar , G , Agostoni , P , Appelman , Y , Arslan , F , Barbato , E , Chen , S-L , Di Serafino , L , Domínguez-Franco , A J , Dupouy , P , Esen , A M , Esen , O B , Hamilos , M , Iwasaki , K , Jensen , L O , Jiménez-Navarro , M F , Katritsis , D G , Kocaman , S A , Koo , B-K , López-Palop ....

مصطلحات موضوعية: Coronary Artery Disease, Fractional Flow Reserve, Myocardial, Humans, Kaplan-Meier Estimate, Prognosis, Severity of Illness Index, Treatment Outcome, meta-analysis, threshold

الوصف: BACKGROUND: Fractional flow reserve (FFR) has become an established tool for guiding treatment, but its graded relationship to clinical outcomes as modulated by medical therapy versus revascularization remains unclear. OBJECTIVES: The study hypothesized that FFR displays a continuous relationship between its numeric value and prognosis, such that lower FFR values confer a higher risk and therefore receive larger absolute benefits from revascularization. METHODS: Meta-analysis of study- and patient-level data investigated prognosis after FFR measurement. An interaction term between FFR and revascularization status allowed for an outcomes-based threshold. RESULTS: A total of 9,173 (study-level) and 6,961 (patient-level) lesions were included with a median follow-up of 16 and 14 months, respectively. Clinical events increased as FFR decreased, and revascularization showed larger net benefit for lower baseline FFR values. Outcomes-derived FFR thresholds generally occurred around the range 0.75 to 0.80, although limited due to confounding by indication. FFR measured immediately after stenting also showed an inverse relationship with prognosis (hazard ratio: 0.86, 95% confidence interval: 0.80 to 0.93; p < 0.001). An FFR-assisted strategy led to revascularization roughly half as often as an anatomy-based strategy, but with 20% fewer adverse events and 10% better angina relief. CONCLUSIONS: FFR demonstrates a continuous and independent relationship with subsequent outcomes, modulated by medical therapy versus revascularization. Lesions with lower FFR values receive larger absolute benefits from revascularization. Measurement of FFR immediately after stenting also shows an inverse gradient of risk, likely from residual diffuse disease. An FFR-guided revascularization strategy significantly reduces events and increases freedom from angina with fewer procedures than an anatomy-based strategy.

العلاقة: https://portal.findresearcher.sdu.dk/da/publications/0a863f98-4de9-4417-b8f1-bf96a96962a6Test

الإتاحة: https://doi.org/10.1016/j.jacc.2014.07.973Test
https://portal.findresearcher.sdu.dk/da/publications/0a863f98-4de9-4417-b8f1-bf96a96962a6Test

المؤلفون: Tonino, Pim A L, De Bruyne, Bernard, Pijls, Nico H J, Siebert, Uwe, Ikeno, Fumiaki, van' t Veer, Marcel, Klauss, Volker, Manoharan, Ganesh, Engstrøm, Thomas, Oldroyd, Keith G, Ver Lee, Peter N, MacCarthy, Philip A, Fearon, William F, Rasmussen [FAME study investigators], Klaus, Frøbert [FAME study investigators], Ole

المساهمون: Cardiovascular Biomechanics, Tonino, Pim A. L, De Bruyne, Bernard, Pijls, Nico H. J, Siebert, Uwe, Ikeno, Fumiaki, van' t. Veer, Marcel, Klauss, Volker, Manoharan, Ganesh, Engstrøm, Thoma, Oldroyd, Keith G, Ver Lee, Peter N, Barbato, Emanuele, Maccarthy, Philip A, Fearon, William F.

المصدر: The New England Journal of Medicine, 360(3), 213-224. Massachussetts Medical Society
Tonino, P A L, De Bruyne, B, Pijls, N H J, Siebert, U, Ikeno, F, van' t Veer, M, Klauss, V, Manoharan, G, Engstrøm, T, Oldroyd, K G, Ver Lee, P N, MacCarthy, P A, Fearon, W F, FAME Study Investigators, Rasmussen [FAME study investigators], K & Frøbert [FAME study investigators], O 2009, ' Fractional flow reserve versus angiography for guiding percutaneous coronary intervention ', The New England Journal of Medicine, vol. 360, no. 3, pp. 213-24 . https://doi.org/10.1056/NEJMoa0807611Test

مصطلحات موضوعية: Male, medicine.medical_treatment, Aged, Angioplasty, Balloon, Coronary, Coronary Artery Disease, Coronary Restenosis, Female, Follow-Up Studies, Health Care Costs, Humans, Kaplan-Meier Estimate, Length of Stay, Middle Aged, Myocardial Infarction, Retreatment, Stents, Coronary Angiography, Drug-Eluting Stents, Fractional Flow Reserve, Myocardial, Fractional flow reserve, Coronary artery disease, Coronary Restenosi, Stent, Drug-Eluting Stent, Angioplasty, Transluminal, Percutaneous Coronary, Myocardial infarction, Angioplasty, Balloon, Coronary, medicine.diagnostic_test, General Medicine, Fractional Flow Reserve, Myocardial, surgical procedures, operative, Cardiology, Radiology, Human, medicine.medical_specialty, Follow-Up Studie, Internal medicine, medicine, cardiovascular diseases, Kaplan-Meiers Estimate, business.industry, Percutaneous coronary intervention, medicine.disease, Health Care Cost, Angiography, Conventional PCI, business

الوصف: Udgivelsesdato: 2009-Jan-15 BACKGROUND: In patients with multivessel coronary artery disease who are undergoing percutaneous coronary intervention (PCI), coronary angiography is the standard method for guiding the placement of the stent. It is unclear whether routine measurement of fractional flow reserve (FFR; the ratio of maximal blood flow in a stenotic artery to normal maximal flow), in addition to angiography, improves outcomes. METHODS: In 20 medical centers in the United States and Europe, we randomly assigned 1005 patients with multivessel coronary artery disease to undergo PCI with implantation of drug-eluting stents guided by angiography alone or guided by FFR measurements in addition to angiography. Before randomization, lesions requiring PCI were identified on the basis of their angiographic appearance. Patients assigned to angiography-guided PCI underwent stenting of all indicated lesions, whereas those assigned to FFR-guided PCI underwent stenting of indicated lesions only if the FFR was 0.80 or less. The primary end point was the rate of death, nonfatal myocardial infarction, and repeat revascularization at 1 year. RESULTS: The mean (+/-SD) number of indicated lesions per patient was 2.7+/-0.9 in the angiography group and 2.8+/-1.0 in the FFR group (P=0.34). The number of stents used per patient was 2.7+/-1.2 and 1.9+/-1.3, respectively (P

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ba00edb01f3f8f5d0004c9a8bfe3b6d0Test
https://hdl.handle.net/11573/1660393Test

المؤلفون: Peter Jüni, Bernard De Bruyne, Dan Eik Høfsten, Henning Kelbæk, Martina Rothenbühler, Nils P. Johnson, Thomas Engstrøm, Stephane Fournier, Mohamed Abdel-Wahab, William F. Fearon, Panagiotis Xaplanteris, Lars Køber, Elmir Omerovic, Pim A.L. Tonino, Emanuele Barbato, Nico H.J. Pijls, Pieter C. Smits, Bianca M. Boxma-de Klerk, Frederik M. Zimmermann

المساهمون: Cardiovascular Biomechanics, Zimmermann, Frederik M, Omerovic, Elmir, Fournier, Stephane, Kelbæk, Henning, Johnson, Nils P, Rothenbühler, Martina, Xaplanteris, Panagioti, Abdel-Wahab, Mohamed, Barbato, Emanuele, Høfsten, Dan Eik, Tonino, Pim A L, Boxma-de Klerk, Bianca M, Fearon, William F, Køber, Lar, Smits, Pieter C, De Bruyne, Bernard, Pijls, Nico H J, Jüni, Peter, Engstrøm, Thomas

المصدر: European heart journal, vol. 40, no. 2, pp. 180-186
Zimmermann, F M, Omerovic, E, Fournier, S, Kelbæk, H, Johnson, N P, Rothenbühler, M, Xaplanteris, P, Abdel-Wahab, M, Barbato, E, Høfsten, D E, Tonino, P A L, Boxma-de Klerk, B M, Fearon, W F, Køber, L, Smits, P C, De Bruyne, B, Pijls, N H J, Jüni, P & Engstrøm, T 2019, ' Fractional flow reserve-guided percutaneous coronary intervention vs. medical therapy for patients with stable coronary lesions : meta-analysis of individual patient data ', European Heart Journal, vol. 40, no. 2, pp. 180-186 . https://doi.org/10.1093/eurheartj/ehy812Test
European Heart Journal, 40(2), 180-186. Oxford University Press
Zimmermann, Frederik M; Omerovic, Elmir; Fournier, Stephane; Kelbæk, Henning; Johnson, Nils P; Rothenbühler, Martina; Xaplanteris, Panagiotis; Abdel-Wahab, Mohamed; Barbato, Emanuele; Høfsten, Dan Eik; Tonino, Pim A L; Boxma-de Klerk, Bianca M; Fearon, William F; Køber, Lars; Smits, Pieter C; De Bruyne, Bernard; Pijls, Nico H J; Jüni, Peter; Engstrøm, Thomas (2019). Fractional flow reserve-guided percutaneous coronary intervention vs. medical therapy for patients with stable coronary lesions: meta-analysis of individual patient data. European Heart Journal, 40(2), pp. 180-186. Oxford University Press 10.1093/eurheartj/ehy812 <http://dx.doi.org/10.1093/eurheartj/ehy812Test>

مصطلحات موضوعية: Male, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Myocardial Infarction, 610 Medicine & health, Fractional flow reserve, Coronary Artery Disease, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Randomized controlled trial, 360 Social problems & social services, Interquartile range, law, Internal medicine, medicine, Humans, Myocardial infarction, Randomized Controlled Trials as Topic, business.industry, Percutaneous coronary intervention, 030229 sport sciences, Middle Aged, medicine.disease, Prognosis, Fractional Flow Reserve, Myocardial, Conventional PCI, Cardiology, Coronary Artery Disease/diagnosis, Coronary Artery Disease/mortality, Coronary Artery Disease/therapy, Female, Fractional Flow Reserve, Myocardial/physiology, Percutaneous Coronary Intervention/adverse effects, Percutaneous Coronary Intervention/mortality, Percutaneous Coronary Intervention/statistics & numerical data, Cardiology and Cardiovascular Medicine, business

الوصف: Aims To assess the effect of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) with contemporary drug-eluting stents on the composite of cardiac death or myocardial infarction (MI) vs. medical therapy in patients with stable coronary lesions. Methods and results We performed a systematic review and meta-Analysis of individual patient data (IPD) of the three available randomized trials of contemporary FFR-guided PCI vs. medical therapy for patients with stable coronary lesions: FAME 2 (NCT01132495), DANAMI-3-PRIMULTI (NCT01960933), and Compare-Acute (NCT01399736). FAME 2 enrolled patients with stable coronary artery disease (CAD), while the other two focused on non-culprit lesions in stabilized patients after acute coronary syndrome. A total of 2400 subjects were recruited from 54 sites world-wide with 1056 randomly assigned to FFR-guided PCI and 1344 to medical therapy. The pre-specified primary outcome was a composite of cardiac death or MI. We included data from extended follow-ups for FAME 2 (up to 5.5 years follow-up) and DANAMI-3-PRIMULTI (up to 4.7 years follow-up). After a median follow-up of 35 months (interquartile range 12-60months), a reduction in the composite of cardiac death or MI was observed with FFR-guided PCI as compared with medical therapy (hazard ratio 0.72, 95% confidence interval 0.54-0.96; P= 0.02). The difference between groups was driven by MI. Conclusion In this IPD meta-Analysis of the three available randomized controlled trials to date, FFR-guided PCI resulted in a reduction of the composite of cardiac death or MI compared with medical therapy, which was driven by a decreased risk of MI.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e868826425ed88b663dd91fd265cec12Test
https://pubmed.ncbi.nlm.nih.gov/30605504Test

المؤلفون: Xaplanteris, P., Fournier, S., Pijls, N. H. J., Fearon, W. F., Barbato, E., Tonino, P. A. L., Engstrøm, T., Kääb, S., Dambrink, J. H., Toth, G. G., Rioufol, G., Piroth, Z., Witt, N., Fröbert, O., Kala, P., Linke, A., Jagic, N., Mates, M., Mavromatis, K., Samady, H., Irimpen, A., Oldroyd, K., Campo, G., Rothenbühler, M., Jüni, P., de Bruyne, B., Mulder, Barbara J. M., et al

المساهمون: Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Department of Cardiology, Örebro University, Cardiovascular Biomechanics, Cardiology, APH - Personalized Medicine, APH - Aging & Later Life, ACS - Heart failure & arrhythmias, Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), CarMeN, laboratoire, Xaplanteris, Panagioti, Fournier, Stephane, Pijls, Nico H J, Fearon, William F, Barbato, Emanuele, Tonino, Pim A L, Engstrøm, Thoma, Kääb, Stefan, Dambrink, Jan-Henk, Rioufol, Gille, Toth, Gabor G, Piroth, Zsolt, Witt, Nil, Fröbert, Ole, Kala, Petr, Linke, Axel, Jagic, Nicola, Mates, Martin, Mavromatis, Kreton, Samady, Habib, Irimpen, Anand, Oldroyd, Keith, Campo, Gianluca, Rothenbühler, Martina, Jüni, Peter, De Bruyne, Bernard

المصدر: New England Journal of Medicine
New England Journal of Medicine, Massachusetts Medical Society, 2018, 379 (3), pp.250--259
The New England Journal of Medicine, 379(3), 250-259. Massachussetts Medical Society
New England journal of medicine, 379(3), 250-259. Massachussetts Medical Society

مصطلحات موضوعية: st-segment elevation, Male, task-force, Coronary Stenosi, Platelet Aggregation Inhibitors/therapeutic use, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Myocardial Infarction, Coronary Disease, Fractional flow reserve, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Coronary artery disease, 0302 clinical medicine, Drug-Eluting Stent, 030212 general & internal medicine, Myocardial infarction, guidelines, Medicine (all), Angina Pectori, Hazard ratio, Drug-Eluting Stents, General Medicine, Middle Aged, Fractional Flow Reserve, myocardial-infarction, 3. Good health, [SDV] Life Sciences [q-bio], Fractional Flow Reserve, Myocardial, Antihypertensive Agent, Coronary Disease/drug therapy, Aged, Angina Pectoris, Antihypertensive Agents, Coronary Stenosis, Female, Follow-Up Studies, Humans, Platelet Aggregation Inhibitors, Retreatment, Percutaneous Coronary Intervention, Cardiology, Platelet aggregation inhibitor, management, Human, medicine.medical_specialty, Angina Pectoris/therapy, conservative treatment, Revascularization, Follow-Up Studie, european-society, NO, 03 medical and health sciences, Internal medicine, General & Internal Medicine, medicine, Myocardial Infarction/epidemiology, Myocardial, coronary, Antihypertensive Agents/therapeutic use, business.industry, Platelet Aggregation Inhibitor, prospective natural-history, Percutaneous coronary intervention, medicine.disease, medical therapy, Retreatment/statistics & numerical data, Conventional PCI, Coronary Stenosis/drug therapy, business

الوصف: Background: we hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease.Methods: among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy and were entered into a registry. The primary end point was a composite of death, myocardial infarction, or urgent revascularization.Results: a total of 888 patients underwent randomization (447 patients in the PCI group and 441 in the medical-therapy group). At 5 years, the rate of the primary end point was lower in the PCI group than in the medical-therapy group (13.9% vs. 27.0%; hazard ratio, 0.46; 95% confidence interval [CI], 0.34 to 0.63; PConclusions: in patients with stable coronary artery disease, an initial FFR-guided PCI strategy was associated with a significantly lower rate of the primary composite end point of death, myocardial infarction, or urgent revascularization at 5 years than medical therapy alone. Patients without hemodynamically significant stenoses had a favorable long-term outcome with medical therapy alone. (Funded by St. Jude Medical and others; FAME 2 ClinicalTrials.gov number, NCT01132495 .).

وصف الملف: application/pdf; text

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f967b46349eccedcf00555746c43c07cTest
http://hdl.handle.net/11392/2391591Test