Impact of a Chronic Total Occlusion on Outcomes After
FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy

J 2024

Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy

OTSUKI, Hisao; Kuniaki TAKAHASHI; Frederik M ZIMMERMANN; Kreton MAVROMATIS; Adel AMINIAN et al.

Základní údaje

Originální název

Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy

Autoři

Vydání

Circulation: Cardiovascular Interventions, Philadelphia, Lippincott Williams & Wilkins, 2024, 1941-7640

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 7.400

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/24:00138885

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

cardiovascular surgery; chronic total occlusion; fractional flow reserve; percutaneous coronary intervention; three-vessel coronary artery disease

Štítky

14110211, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 20. 2. 2025 08:41, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND: The clinical impact of a chronic total occlusion (CTO) in patients with 3-vessel coronary artery disease undergoing fractional flow reserve-guided percutaneous coronary intervention (PCI) with current-generation drug-eluting stents or coronary artery bypass grafting (CABG) is unclear. METHODS: The FAME 3 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3) compared fractional flow reserve-guided PCI with CABG in patients with 3-vessel coronary artery disease. The primary end point was major adverse cardiac and cerebrovascular events, a composite of death, myocardial infarction, stroke, or repeat revascularization at 1 year. In this substudy, the 3-year outcomes were analyzed in patients with or without a CTO. RESULTS: Of the patients randomized to PCI or CABG in the FAME 3 trial, 305 (21%) had a CTO. In the PCI arm, revascularization of the CTO was attempted in 61% with a procedural success rate of 88%. The incidence of major adverse cardiac and cerebrovascular events at 3 years was not significantly different between those with or without a CTO in both the PCI (15.2% versus 20.1%; adjusted hazard ratio, 0.62 [95% CI, 0.38-1.03]; P=0.07) and the CABG (13.0% versus 12.9%; adjusted hazard ratio, 0.96 [95% CI, 0.55-1.66]; P=0.88) arms. In those without a CTO, PCI was associated with a significantly higher risk of major adverse cardiac and cerebrovascular events compared with CABG (adjusted hazard ratio, 1.61 [95% CI, 1.20-2.17]; P<0.01) but not in those with a CTO (adjusted hazard ratio, 1.21 [95% CI, 0.64-2.28]; P=0.56; Pinteraction=0.31). CONCLUSIONS: The presence of a CTO did not significantly impact the treatment effect of PCI versus CABG at 3 years in patients with 3-vessel coronary artery disease.

Citovat

OTSUKI, Hisao; Kuniaki TAKAHASHI; Frederik M ZIMMERMANN; Kreton MAVROMATIS; Adel AMINIAN; Nikola JAGIC; Jan-Henk E DAMBRINK; Petr KALA; Philip MACCARTHY; Nils WITT; Yuhei KOBAYASHI; Tatsunori TAKAHASHI; Y Joseph WOO; Alan C YEUNG; De Bruyne BERNARD; Nico H J PIJLS a William F FEARON. Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy. Circulation: Cardiovascular Interventions. Philadelphia: Lippincott Williams & Wilkins, 2024, roč. 17, č. 11, s. 1-10. ISSN 1941-7640. Dostupné z: https://doi.org/10.1161/CIRCINTERVENTIONS.124.014300.

@article{2478477,
   author = {Otsuki, Hisao and Takahashi, Kuniaki and Zimmermann, Frederik M and Mavromatis, Kreton and Aminian, Adel and Jagic, Nikola and Dambrink, JanandHenk E and Kala, Petr and Maccarthy, Philip and Witt, Nils and Kobayashi, Yuhei and Takahashi, Tatsunori and Woo, Y Joseph and Yeung, Alan C and Bernard, De Bruyne and Pijls, Nico H J and Fearon, William F},
   article_location = {Philadelphia},
   article_number = {11},
   doi = {https://doi.org/10.1161/CIRCINTERVENTIONS.124.014300},
   keywords = {cardiovascular surgery; chronic total occlusion; fractional flow reserve; percutaneous coronary intervention; three-vessel coronary artery disease},
   language = {eng},
   issn = {1941-7640},
   journal = {Circulation: Cardiovascular Interventions},
   title = {Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy},
   url = {https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.124.014300},
   volume = {17},
   year = {2024}
}

TY  - JOUR
ID  - 2478477
AU  - Otsuki, Hisao - Takahashi, Kuniaki - Zimmermann, Frederik M - Mavromatis, Kreton - Aminian, Adel - Jagic, Nikola - Dambrink, Jan-Henk E - Kala, Petr - Maccarthy, Philip - Witt, Nils - Kobayashi, Yuhei - Takahashi, Tatsunori - Woo, Y Joseph - Yeung, Alan C - Bernard, De Bruyne - Pijls, Nico H J - Fearon, William F
PY  - 2024
TI  - Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy
JF  - Circulation: Cardiovascular Interventions
VL  - 17
IS  - 11
SP  - 1-10
EP  - 1-10
PB  - Lippincott Williams & Wilkins
SN  - 19417640
KW  - cardiovascular surgery
KW  - chronic total occlusion
KW  - fractional flow reserve
KW  - percutaneous coronary intervention
KW  - three-vessel coronary artery disease
UR  - https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.124.014300
N2  - BACKGROUND: The clinical impact of a chronic total occlusion (CTO) in patients with 3-vessel coronary artery disease undergoing fractional flow reserve-guided percutaneous coronary intervention (PCI) with current-generation drug-eluting stents or coronary artery bypass grafting (CABG) is unclear. METHODS: The FAME 3 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation 3) compared fractional flow reserve-guided PCI with CABG in patients with 3-vessel coronary artery disease. The primary end point was major adverse cardiac and cerebrovascular events, a composite of death, myocardial infarction, stroke, or repeat revascularization at 1 year. In this substudy, the 3-year outcomes were analyzed in patients with or without a CTO. RESULTS: Of the patients randomized to PCI or CABG in the FAME 3 trial, 305 (21%) had a CTO. In the PCI arm, revascularization of the CTO was attempted in 61% with a procedural success rate of 88%. The incidence of major adverse cardiac and cerebrovascular events at 3 years was not significantly different between those with or without a CTO in both the PCI (15.2% versus 20.1%; adjusted hazard ratio, 0.62 [95% CI, 0.38-1.03]; P=0.07) and the CABG (13.0% versus 12.9%; adjusted hazard ratio, 0.96 [95% CI, 0.55-1.66]; P=0.88) arms. In those without a CTO, PCI was associated with a significantly higher risk of major adverse cardiac and cerebrovascular events compared with CABG (adjusted hazard ratio, 1.61 [95% CI, 1.20-2.17]; P<0.01) but not in those with a CTO (adjusted hazard ratio, 1.21 [95% CI, 0.64-2.28]; P=0.56; Pinteraction=0.31). CONCLUSIONS: The presence of a CTO did not significantly impact the treatment effect of PCI versus CABG at 3 years in patients with 3-vessel coronary artery disease.
ER  -

OTSUKI, Hisao; Kuniaki TAKAHASHI; Frederik M ZIMMERMANN; Kreton MAVROMATIS; Adel AMINIAN; Nikola JAGIC; Jan-Henk E DAMBRINK; Petr KALA; Philip MACCARTHY; Nils WITT; Yuhei KOBAYASHI; Tatsunori TAKAHASHI; Y Joseph WOO; Alan C YEUNG; De Bruyne BERNARD; Nico H J PIJLS a William F FEARON. Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy. \textit{Circulation: Cardiovascular Interventions}. Philadelphia: Lippincott Williams \&{} Wilkins, 2024, roč.~17, č.~11, s.~1-10. ISSN~1941-7640. Dostupné z: https://doi.org/10.1161/CIRCINTERVENTIONS.124.014300.

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