{"id":91377,"date":"2020-10-17T10:43:43","date_gmt":"2020-10-17T07:43:43","guid":{"rendered":"https:\/\/en.buradabiliyorum.com\/physiology-guided-percutaneous-coronary-intervention-optimization-strategy-may-lead-to-improved-outcomes\/"},"modified":"2020-10-17T10:43:43","modified_gmt":"2020-10-17T07:43:43","slug":"physiology-guided-percutaneous-coronary-intervention-optimization-strategy-may-lead-to-improved-outcomes","status":"publish","type":"post","link":"https:\/\/buradabiliyorum.com\/en\/physiology-guided-percutaneous-coronary-intervention-optimization-strategy-may-lead-to-improved-outcomes\/","title":{"rendered":"#Physiology-guided percutaneous coronary intervention optimization strategy may lead to improved outcomes"},"content":{"rendered":"

“#Physiology-guided percutaneous coronary intervention optimization strategy may lead to improved outcomes<\/strong>”<\/p>\n

\n Results from the randomized controlled TARGET FFR trial show that while a physiology-guided percutaneous coronary intervention (PCI) optimization strategy did not achieve a significant increase in the proportion of patients with final FFR \u22650.90, it reduced the proportion of patients with a residual FFR \u22640.80 following PCI.\n <\/p>\n

Findings were reported today at TCT Connect, the 32nd annual scientific symposium of the Cardiovascular Research Foundation (CRF).<\/p>\n

260 patients were successfully randomized between March 2018 and November 2019 at a single site. Following angiographically successful PCI procedures, patients were randomized (1:1) to receive either a physiology-guided incremental optimization strategy (PIOS intervention group, n=131) or blinded post-PCI coronary physiology measurements (control group, n=129). Patients undergoing successful, standard-of-care PCI for either stable angina or medically stabilized non-ST-segment-elevation myocardial infarction (NSTEMI) were eligible for randomization.<\/p>\n

The trial’s primary endpoint was defined as the proportion of patients with a final post-PCI FFR result \u22650.90. The study found that the incidence of final FFR \u22650.90 was 10% higher in the PIOS group than the control group but that the difference was not statistically significant (38.1% vs. 28.1%, p=0.099). However, the study’s secondary endpoint, the proportion of patients with final FFR \u22640.80, was significantly lower in the PIOS group (18.6% vs 29.8%, p=0.045).<\/p>\n

Based on FFR pullback assessment of the stented vessel, a target for further optimization was present in 60 of the 131 (46%) patients randomized to PIOS, and operators considered it app<\/a>ropriate to perform additional post-dilatation +\/- stenting in 40 of these 60 (66%) patients. Among patients who had further intervention\/optimization performed, mean post-PCI FFR increased significantly from 0.76 to 0.82 (p<.001 and=\"\" mean=\"\" coronary=\"\" flow=\"\" reserve=\"\" increased=\"\" from=\"\" to=\"\" wp_automatic_readability=\"15.610456553756\">“When assessing the proposed optimal post-PCI FFR cutoff value of \u22650.90, we found that the majority of patients with angiographically acceptable PCI results actually have a physiologically suboptimal outcome,” said Damien Collison, MD, Interventional Cardiologist at the Golden Jubilee National Hospital, Glasgow, Scotland. “Up to 30% of patients may even have a final FFR result that remains below the guideline-directed threshold for performing revascularization in the first place. In our randomized controlled trial, application of an FFR-guided optimization strategy after stenting led to improvements in both FFR and CFR and significantly reduced the proportion of patients with a final post-PCI FFR \u22640.80.\n <\/p>\n\n

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Results of an individual patient data pooled analysis reported at RCT Connect\n <\/p><\/div>\n

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\n Provided by
\n Cardiovascular Research Foundation
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\n Citation<\/strong>:
\n Physiology-guided percutaneous coronary intervention optimization strategy may lead to improved outcomes (2020, October 17)
\n retrieved 17 October 2020
\n from https:\/\/medicalxpress.com\/news<\/a>\/2020-10-physiology-guided-percutaneous-coronary-intervention-optimization.html<\/p>\n

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