ArticleJournal of the American Heart Association2017
Clinical Outcomes of Deferred Lesions With Angiographically Insignificant Stenosis But Low Fractional Flow Reserve.
Article in Journal of the American Heart Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01621438 (Influence of Total Atherosclerotic Burden Assessed by 3-vessel Fractional Flow Reserve), which is not on this map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Influence of Total Atherosclerotic Burden Assessed by 3-vessel Fractional Flow Reserve (FFR) on the Clinical Outcomes of the Patients With Multi-vessel Disease
Who cites it
9 citing papers in PubMed.
- Angiography versus angio-based fractional flow in assessing intracranial vertebrobasilar artery stenosis.European radiology · 2026Article
- Prognostic role of discordance between quantitative flow ratio and visual estimation in revascularization guidance.European heart journal open · 2024Article
- Clinical use of physiological lesion assessment using pressure guidewires: an expert consensus document of the Japanese association of cardiovascular intervention and therapeutics-update 2022.Cardiovascular intervention and therapeutics · 2022Review
- The Continuum of Invasive Techniques for the Assessment of Intermediate Coronary Lesions.Diagnostics (Basel, Switzerland) · 2022Review
- Physiologic Lesion Assessment to Optimize Multivessel Disease.Current cardiology reports · 2022Review
- Relevance of anatomical, plaque, and hemodynamic characteristics of non-obstructive coronary lesions in the prediction of risk for acute coronary syndrome.European radiology · 2019Article
- Angiographically insignificant yet ischemia-causing coronary lesions: a case for routine use of invasive physiologic testing during diagnostic cardiac catheterization.Journal of thoracic disease · 2018Article
- Functional Approach for Coronary Artery Disease: Filling the Gap Between Evidence and Practice.Korean circulation journal · 2018Review
- Fractional Flow Reserve in Angiographically Insignificant Stenoses: Unmasking the Lesion or Creating Disease?Journal of the American Heart Association · 2017Article
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundData are limited regarding outcomes of deferred lesions in patients with angiographically insignificant stenosis but low fractional flow reserve (FFR). We investigated the natural history of angiographically insignificant stenosis with low FFR among patients who underwent routine 3-vessel FFR measurement. METHODS AND
resultsFrom December 2011 to March 2014, 1136 patients with 3298 vessels underwent routine 3-vessel FFR measurement (3V FFR-FRIENDS study, ClinicalTrials.gov identifier NCT01621438), and this study analyzed the 2-year clinical outcomes of 1024 patients with 2124 lesions with angiographically insignificant stenosis (percentage of diameter stenosis <50%), in which revascularization was deferred. All lesions were classified according to FFR values, using a cutoff of 0.80 (high FFR >0.80 versus low FFR ≤0.80). The primary end point was outcome of major adverse cardiovascular events (a composite of cardiac death, myocardial infarction, and ischemia-driven revascularization) at 2 years. Mean angiographic percentage of diameter stenosis and FFR of total lesions were 32.5±10.3% and 0.91±0.08%, respectively. Among the total lesions with angiographically insignificant stenosis, 8.7% showed low FFR (185 lesions). The incidence of lesions with low FFR was 2.5%, 3.8%, 9.0%, and 15.1% in categories of percentage of diameter stenosis <20%, 20% to 30%, 30% to 40%, and 40% to 50%, respectively. At 2-year follow-up, the low-FFR group showed a significantly higher risk of major adverse cardiovascular events compared with the high FFR group (3.3% versus 1.2%, hazard ratio: 3.371; 95% CI, 1.346-8.442;
conclusionsIn deferred angiographically insignificant stenosis, lesions with low FFR showed significantly higher event rates than those with high FFR. FFR was an independent predictor of future major adverse cardiovascular events in lesions with angiographically insignificant stenosis. CLINICAL
trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01621438.
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