Graft patency after FFR-guided versus angiography-guided
coronary artery bypass grafting: the GRAFFITI trial

J 2019

Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial

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

Basic information

Original name

Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial

Authors

TOTH, Gabor G. (40 Austria), Bernard DE BRUYNE (56 Belgium), Petr KALA (203 Czech Republic, belonging to the institution), Flavio RIBICHINI (380 Italy), Filip CASSELMAN (56 Belgium), Ruben RAMOS (620 Portugal), Zsolt PIROTH (348 Hungary), Stephane FOURNIER (56 Belgium), Anna PICCOLI (380 Italy), Carlos VAN MIEGHEM (56 Belgium), Martin PENICKA (56 Belgium), Martin MATES (203 Czech Republic), Petr NEMEC (203 Czech Republic), Frank VAN PRAET (56 Belgium), Bernard STOCKMAN (56 Belgium), Ivan DEGRIEK (56 Belgium) and Emanuele BARBATO (380 Italy, guarantor)

Edition

Eurointervention, Toulouse, Europa edition, 2019, 1774-024X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

France

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.993

RIV identification code

RIV/00216224:14110/19:00112632

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.4244/EIJ-D-19-00463

UT WoS

000501563600013

Keywords in English

fractional flow reserve; multiple vessel disease

Abstract

V originále

Aims: The aim of this study was to assess prospectively the clinical benefits of fractional flow reserve (FFR) in guiding coronary artery bypass grafting (CABG). Methods and results: GRAFFITI is a single-blinded, prospective, multicentre, randomised controlled trial of FFR-guided versus angiography-guided CABG. We enrolled patients undergoing coronary angiography, having a significantly diseased left anterior descending artery or left main stem and at least one more major coronary artery with intermediate stenosis, assessed by FFR. Surgical strategy was defined based on angiography, blinded to FFR values prior to randomisation. After randomisation, patients were operated on either following the angiography-based strategy (angiography-guided group) or according to FFR, i.e., with an FFR <= 0.80 as cut-off for grafting (FFR-guided group). The primary endpoint was graft patency at 12 months. Between March 2012 and December 2016, 172 patients were randomised either to the angiography-guided group (84 patients) or to the FFR-guided group (88 patients). The patients had a median of three [3; 4] lesions; diameter stenosis was 65% (50%; 80%), FFR was 0.72 (0.50; 0.82). Compared to the angiography-guided group, the FFR-guided group received fewer anastomoses (3 [3; 3] vs 2 [2; 3], respectively; p=0.004). One-year angiographic follow-up showed no difference in overall graft patency (126 [80%] vs 113 [81%], respectively; p=0.885). One-year clinical follow-up, available in 98% of patients, showed no difference in the composite of death, myocardial infarction, target vessel revascularisation and stroke. Conclusions: FFR guidance of CABG has no impact on one-year graft patency, but it is associated with a simplified surgical procedure. ClinicalTrials.gov Identifier: NCT01810224

Citovat

TOTH, Gabor G., Bernard DE BRUYNE, Petr KALA, Flavio RIBICHINI, Filip CASSELMAN, Ruben RAMOS, Zsolt PIROTH, Stephane FOURNIER, Anna PICCOLI, Carlos VAN MIEGHEM, Martin PENICKA, Martin MATES, Petr NEMEC, Frank VAN PRAET, Bernard STOCKMAN, Ivan DEGRIEK and Emanuele BARBATO. Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial. Eurointervention. Toulouse: Europa edition, 2019, vol. 15, No 11, p. "E999"-"E1008", 10 pp. ISSN 1774-024X. Available from: https://dx.doi.org/10.4244/EIJ-D-19-00463.

@article{1607158,
   author = {Toth, Gabor G. and De Bruyne, Bernard and Kala, Petr and Ribichini, Flavio and Casselman, Filip and Ramos, Ruben and Piroth, Zsolt and Fournier, Stephane and Piccoli, Anna and Van Mieghem, Carlos and Penicka, Martin and Mates, Martin and Nemec, Petr and Van Praet, Frank and Stockman, Bernard and Degriek, Ivan and Barbato, Emanuele},
   article_location = {Toulouse},
   article_number = {11},
   doi = {http://dx.doi.org/10.4244/EIJ-D-19-00463},
   keywords = {fractional flow reserve; multiple vessel disease},
   language = {eng},
   issn = {1774-024X},
   journal = {Eurointervention},
   title = {Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial},
   url = {http://dx.doi.org/10.4244/EIJ-D-19-00463},
   volume = {15},
   year = {2019}
}

TY  - JOUR
ID  - 1607158
AU  - Toth, Gabor G. - De Bruyne, Bernard - Kala, Petr - Ribichini, Flavio - Casselman, Filip - Ramos, Ruben - Piroth, Zsolt - Fournier, Stephane - Piccoli, Anna - Van Mieghem, Carlos - Penicka, Martin - Mates, Martin - Nemec, Petr - Van Praet, Frank - Stockman, Bernard - Degriek, Ivan - Barbato, Emanuele
PY  - 2019
TI  - Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial
JF  - Eurointervention
VL  - 15
IS  - 11
SP  - "E999"-"E1008"
EP  - "E999"-"E1008"
PB  - Europa edition
SN  - 1774024X
KW  - fractional flow reserve
KW  - multiple vessel disease
UR  - http://dx.doi.org/10.4244/EIJ-D-19-00463
L2  - http://dx.doi.org/10.4244/EIJ-D-19-00463
N2  - Aims: The aim of this study was to assess prospectively the clinical benefits of fractional flow reserve (FFR) in guiding coronary artery bypass grafting (CABG). Methods and results: GRAFFITI is a single-blinded, prospective, multicentre, randomised controlled trial of FFR-guided versus angiography-guided CABG. We enrolled patients undergoing coronary angiography, having a significantly diseased left anterior descending artery or left main stem and at least one more major coronary artery with intermediate stenosis, assessed by FFR. Surgical strategy was defined based on angiography, blinded to FFR values prior to randomisation. After randomisation, patients were operated on either following the angiography-based strategy (angiography-guided group) or according to FFR, i.e., with an FFR <= 0.80 as cut-off for grafting (FFR-guided group). The primary endpoint was graft patency at 12 months. Between March 2012 and December 2016, 172 patients were randomised either to the angiography-guided group (84 patients) or to the FFR-guided group (88 patients). The patients had a median of three [3; 4] lesions; diameter stenosis was 65% (50%; 80%), FFR was 0.72 (0.50; 0.82). Compared to the angiography-guided group, the FFR-guided group received fewer anastomoses (3 [3; 3] vs 2 [2; 3], respectively; p=0.004). One-year angiographic follow-up showed no difference in overall graft patency (126 [80%] vs 113 [81%], respectively; p=0.885). One-year clinical follow-up, available in 98% of patients, showed no difference in the composite of death, myocardial infarction, target vessel revascularisation and stroke. Conclusions: FFR guidance of CABG has no impact on one-year graft patency, but it is associated with a simplified surgical procedure. ClinicalTrials.gov Identifier: NCT01810224
ER  -

TOTH, Gabor G., Bernard DE BRUYNE, Petr KALA, Flavio RIBICHINI, Filip CASSELMAN, Ruben RAMOS, Zsolt PIROTH, Stephane FOURNIER, Anna PICCOLI, Carlos VAN MIEGHEM, Martin PENICKA, Martin MATES, Petr NEMEC, Frank VAN PRAET, Bernard STOCKMAN, Ivan DEGRIEK and Emanuele BARBATO. Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial. \textit{Eurointervention}. Toulouse: Europa edition, 2019, vol.~15, No~11, p.~''E999''-''E1008'', 10 pp. ISSN~1774-024X. Available from: https://dx.doi.org/10.4244/EIJ-D-19-00463.

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