J 2018

Study Design of the Graft Patency After FFR-Guided Versus Angiography-Guided CABG Trial (GRAFFITI)

TOTH, Gabor G., Bernard DE BRUYNE, Petr KALA, Flavio L. RIBICHINI, Filip CASSELMAN et. al.

Basic information

Original name

Study Design of the Graft Patency After FFR-Guided Versus Angiography-Guided CABG Trial (GRAFFITI)

Authors

TOTH, Gabor G., Bernard DE BRUYNE (56 Belgium), Petr KALA (203 Czech Republic, belonging to the institution), Flavio L. RIBICHINI (380 Italy), Filip CASSELMAN (56 Belgium), Ruben RAMOS (620 Portugal), Zsolt PIROTH (348 Hungary), Stephane FOURNIER (56 Belgium), Carlos VAN MIEGHEM (56 Belgium), Martin PENICKA (56 Belgium), Martin MATES (203 Czech Republic), Frank VAN PRAET (56 Belgium), Ivan DEGRIEK (56 Belgium) and Emanuele BARBATO (56 Belgium, guarantor)

Edition

Journal of Cardiovascular Translational Research, New York, Springer, 2018, 1937-5387

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.756

RIV identification code

RIV/00216224:14110/18:00104189

Organization unit

Faculty of Medicine

DOI

UT WoS

000443418700001

Keywords in English

Coronary artery bypass graft surgery; Fractional flow reserve; Coronary angiography; Graft patency

Tags

Tags

International impact, Reviewed
Změněno: 10/2/2019 19:52, Soňa Böhmová

Abstract

V originále

Clinical benefit of invasive functionally guided revascularization has been mostly investigated and proven for percutaneous coronary intervention. It has never been prospectively evaluated whether a systematic fractional flow reserve (FFR) assessment is also beneficial in guiding coronary artery bypass graft surgery (CABG). The objective of the GRAft patency after FFR-guided versus angiography-guIded CABG (GRAFFITI) trial was to compare an FFR-guided revascularization strategy to the traditional angiography-guided revascularization strategy for patients undergoing CABG. Patients were enrolled with significantly diseased left anterior descending or left main stem and at least one major coronary artery with angiographically intermediate stenosis (30-90% diameter stenosis) that was assessed by FFR. Thereafter, while the FFR values were kept concealed, cardiac surgeons decided their intended procedural strategy based on the coronary angiography alone. At this point, patients underwent 1:1 randomization to either an FFR-guided or an angiography-guided CABG strategy. In case the patient was randomized to angiography-guided arm, cardiac surgeons kept their intended procedural strategy, i.e., CABG was guided solely on the basis of the coronary angiography. In case the patient was randomized to the FFR-guided arm, FFR values were disclosed to the surgeons who revised the surgical protocol according to the functional significance of each coronary stenosis. The primary endpoint of the trial was the rate of graft occlusion at 12 months, assessed by coronary computed tomography or coronary angiography. The secondary endpoints were (1) length of postoperative hospital stay; (2) changes in surgical strategy depending upon FFR results (in FFR-guided group only); and (3) rate of major adverse cardiac and cerebrovascular events, i.e., composite of death, myocardial infarction, stroke, and any revascularization during the follow-up period. This study is the first prospective randomized trial investigating potential clinical benefits, associated with FFR-guided surgical revascularization. Trial registration: NCT01810224.