Optical coherence tomography compared with fractional flow reserve guided approach in acute coronary syndromes: A propensity matched analysis

被引：16

作者：

D'Ascenzo, Fabrizio ^{[1
]}

Iannaccone, Mario ^{[1
]}

De Filippo, Ovidio ^{[1
]}

Leone, Antonio Maria ^{[2
]}

Niccoli, Giampaolo ^{[2
]}

Zilio, Filippo ^{[3
]}

Ugo, Fabrizio ^{[4
]}

Cerrato, Enrico ^{[5
]}

Fineschi, Massimo ^{[6
]}

Mancone, Massimo ^{[7
]}

Rigattieri, Stefano ^{[8
]}

Amabile, Nicolas ^{[9
]}

Ferlini, Marco ^{[10
]}

Sardella, Gennaro ^{[7
]}

Cresti, Alberto ^{[11
]}

Barbero, Umberto ^{[1
]}

Motreff, Pascal ^{[12
]}

Colombo, Francesco ^{[4
]}

Colangelo, Salvatore ^{[4
]}

Garbo, Roberto ^{[4
]}

Biondi-Zoccai, Giuseppe ^{[13
,14
]}

Tamburino, Corrado ^{[15
]}

Montefusco, Antonio ^{[1
]}

Omede, Pierlugi ^{[1
]}

Moretti, Claudio ^{[1
]}

D'amico, Maurizio ^{[1
]}

Souteyrand, Geraud ^{[12
,16
]}

Gaita, Fiorenzo ^{[1
]}

Limbruno, Ugo ^{[17
]}

Picchi, Andrea ^{[11
]}

机构：

[1] Univ Turin, Dept Cardiol, Citta Sci & Salute, Turin, Italy

[2] Univ Cattolica Sacro Cuore, Dept Cardiovasc Med, Rome, Italy

[3] Univ Padua, Dept Cardiac Thorac & Vasc Sci, Padua, Italy

[4] SG Bosco Hosp, Dept Cardiol, Turin, Italy

[5] Orbassano & Infermi Hosp, San Luigi Gonzaga Univ Hosp, Intervent Cardiol Unit, Turin, Italy

[6] Policlin S Mariaalle, Dept Intervent Cardiol, Siena, Italy

[7] Sapienza Univ Rome, Dept Cardiovasc Resp Nephrol Anesthesiol & Geriat, Rome, Italy

[8] Sandro Pertini Hosp, Intervent Cardiol, Rome, Italy

[9] Inst Mutualiste Montsouris, Cardiol Dept, Paris, France

[10] Fdn IRCCS, Policlin San Matteo, SC Cardiol, Pavia, Italy

[11] Misericordia Hosp, Cardiol Dept, Grosseto, Italy

[12] CHU Clermont Ferrand, Cardiol Dept, F-63000 Clermont Ferrand, France

[13] Sapienza Univ Rome, Dept Med Surg Sci & Biotechnol, Latina, Italy

[14] IRCCS Neuromed, Dept AngioCardioNeurol, Pozzilli, Italy

[15] Univ Catania, Ferrarotto Hosp, Cardiothorac Vasc Dept, Catania, Italy

[16] Auvergne Univ, CNRS, UMR 6284, Cardio Vasc Intervent Therapy & Imaging CaVITI, Clermont Ferrand, France

[17] Azienda USL Toscana Sudest, UOC Cardiol, Grosseto, Italy

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2017年 / 244卷

关键词：

Optical coherence tomography; Acute coronary syndrome; Drug eluting stent; Fractional flow reserve; ELEVATION MYOCARDIAL-INFARCTION; INTRAVASCULAR ULTRASOUND; INTERVENTION; DISEASE; OUTCOMES; IMPACT;

D O I：

10.1016/j.ijcard.2017.05.108

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aim: To compare in patients with ACS (acute coronary syndromes) a PCI (percutaneous coronary intervention) approach based on FFR (fractional flow reserve) vs. one based on OCT (optical coherence tomography). Methods and results: Consecutive patients admitted for ACS and treated with a PCI approach based on OCT or on FFR (recruited in two different studies) were compared and matched with propensity score analysis. Target Lesion revascularization (TLR) was the primary end point, while major adverse cardiovascular events [MACEs defined as the composite of death from cardiac causes, non-fatal MI, clinically driven target vessel revascularization (TVR), or re-hospitalization due to unstable angina] were the secondary ones. Sub-group analysis was performed for patients with FFR/OCT performed on culprit lesions and not. 285 patients were enrolled in the OCT-guided group and 335 in the FFR-guided group, 197 for each being selected after propensity score. After 25 months (range: 7-39 months), OCT-guided group were exposed to lower incidence of TLR (4.1% vs. 14.2% p < 0.01) compared with FFR-guided group without impact on MACEs (14.2% vs. 14.2%, p = 1) or all-cause death (3.6% vs. 1.1%, p = 0.34). At Kaplan-Maier curve analysis for MACEs OCT-guided and FFR-guided groups showed similar outcomes (HR 1.19, CI 0.65-2.2, p = 0.54). Subgroup analysis on culprit and not culprit vessel demonstrated consistent results. Conclusions: An OCT based approach in ACS patients offers a reduction in TLR when compared to a PCI-FFR driven. These findings should be confirmed in randomized controlled trial. (C) 2017 Elsevier B.V. All rights reserved.

引用

页码：54 / 58

页数：5

共 19 条

[1] Standards of Medical Care in Diabetes-2014 [J].

不详 .

DIABETES CARE, 2014, 37 :S14-S80

[2] Residual thrombin potential predicts cardiovascular death in acute coronary syndrome patients undergoing percutaneous coronary intervention [J].

Attanasio, Monica ;

Marcucci, Rossella ;

Gori, Anna Maria ;

Paniccia, Rita ;

Valente, Serafina ;

Balzi, Daniela ;

Barchielli, Alessandro ;

Carrabba, Nazario ;

Valenti, Renato ;

Antoniucci, David ;

Abbate, Rosanna ;

Gensini, Gian Franco .

THROMBOSIS RESEARCH, 2016, 147 :52-57

[3] Impact of Microvascular Obstruction on the Assessment of Coronary Flow Reserve, Index of Microcirculatory Resistance, and Fractional Flow Reserve After ST-Segment Elevation Myocardial Infarction [J].

Cuculi, Florim ;

De Maria, Giovanni Luigi ;

Meier, Pascal ;

Dall'Armellina, Erica ;

de Caterina, Alberto R. ;

Channon, Keith M. ;

Prendergast, Bernard D. ;

Choudhury, Robin C. ;

Forfar, John C. ;

Kharbanda, Rajesh K. ;

Banning, Adrian P. .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2014, 64 (18) :1894-1904

[4] Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions [J].

D'Ascenzo, Fabrizio ;

Barbero, Umberto ;

Cerrato, Enrico ;

Lipinski, Michael J. ;

Omede, Pierluigi ;

Montefusco, Antonio ;

Taha, Salma ;

Naganuma, Toru ;

Reith, Sebastian ;

Voros, Szilard ;

Latib, Azeem ;

Gonzalo, Nieves ;

Quadri, Giorgio ;

Colombo, Antonio ;

Biondi-Zoccai, Giuseppe ;

Escaned, Javier ;

Moretti, Claudio ;

Gaita, Fiorenzo .

AMERICAN HEART JOURNAL, 2015, 169 (05) :663-673

[5] Use and Misuse of Multivariable Approaches in Interventional Cardiology Studies on Drug-Eluting Stents: A Systematic Review [J].

D'Ascenzo, Fabrizio ;

Cavallero, Erika ;

Biondi-Zoccai, Giuseppe ;

Moretti, Claudio ;

Omede, Pierluigi ;

Bollati, Mario ;

Castagno, Davide ;

Modena, Maria Grazia ;

Gaita, Fiorenzo ;

Sheiban, Imad .

JOURNAL OF INTERVENTIONAL CARDIOLOGY, 2012, 25 (06) :611-621

[6] Prevalence and non-invasive predictors of left main or three-vessel coronary disease: evidence from a collaborative international meta-analysis including 22 740 patients [J].

D'Ascenzo, Fabrizio ;

Presutti, Davide Giacomo ;

Picardi, Elisa ;

Moretti, Claudio ;

Omede, Pierluigi ;

Sciuto, Filippo ;

Novara, Marco ;

Yan, Andrew T. ;

Goodman, Shaun ;

Mahajan, Nitin ;

Kosuge, Masami ;

Palazzuoli, Alberto ;

Jong, Gwo-Ping ;

Isma'eel, Hussain ;

Budoff, Matthew J. ;

Rubinshtein, Ronen ;

Gewirtz, Henry ;

Reed, Matthew J. ;

Theroux, Pierre ;

Biondi-Zoccai, Giuseppe ;

Modena, Maria Grazia ;

Sheiban, Imad ;

Gaita, Fiorenzo .

HEART, 2012, 98 (12) :914-919

[7] Fractional flow reserve in patients with prior myocardial infarction [J].

De Bruyne, B ;

Pijls, NHJ ;

Bartunek, J ;

Kulecki, K ;

Bech, JW ;

De Winter, H ;

Van Crombrugge, P ;

Heyndrickx, GR ;

Wijns, W .

CIRCULATION, 2001, 104 (02) :157-162

[8] Fractional Flow Reserve-Guided PCI versus Medical Therapy in Stable Coronary Disease [J].

De Bruyne, Bernard ;

Pijls, Nico H. J. ;

Kalesan, Bindu ;

Barbato, Emanuele ;

Tonino, Pim A. L. ;

Piroth, Zsolt ;

Jagic, Nikola ;

Mobius-Winckler, Sven ;

Rioufol, Gilles ;

Witt, Nils ;

Kala, Petr ;

MacCarthy, Philip ;

Engstrom, Thomas ;

Oldroyd, Keith G. ;

Mavromatis, Kreton ;

Manoharan, Ganesh ;

Verlee, Peter ;

Frobert, Ole ;

Curzen, Nick ;

Johnson, Jane B. ;

Jueni, Peter ;

Fearon, William F. .

NEW ENGLAND JOURNAL OF MEDICINE, 2012, 367 (11) :991-1001

[9] Contemporary antithrombotic strategies in patients with acute coronary syndromes managed without revascularization: insights from the EYESHOT study [J].

De Luca, Leonardo ;

Leonardi, Sergio ;

Smecca, Ignazio Maria ;

Formigli, Dario ;

Lucci, Donata ;

Gonzini, Lucio ;

Tuccillo, Bernardino ;

Olivari, Zoran ;

Gulizia, Michele Massimo ;

Bovenzi, Francesco Maria ;

De Servi, Stefano ;

De Luca, L. ;

De Servi, S. ;

Caporale, R. ;

Cavallini, C. ;

Ceravolo, R. ;

Formigli, D. ;

Leonardi, S. ;

Lupi, A. ;

Musumeci, G. ;

Rakar, S. ;

Smecca, I. M. ;

Maggioni, A. P. ;

Lucci, D. ;

Lorimer, A. ;

Orsini, G. ;

Gonzini, L. ;

Fabbri, G. ;

Bianchini, E. ;

Abrignani, M. G. ;

Bonura, F. ;

Trimarco, B. ;

Galasso, G. ;

Misuraca, G. ;

Manes, M. T. ;

Tuccillo, B. ;

Irace, L. ;

Olivari, Z. ;

Totis, O. ;

Ledda, A. ;

Mauro, C. ;

Boccalatte, M. ;

Iliceto, S. ;

Cacciavillani, L. ;

Savonitto, S. ;

Tortorella, G. ;

Esposito, L. ;

De Rosa, P. ;

Calabro, P. ;

Bianchi, R. .

EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY, 2015, 1 (03) :168-178

[10] CONTRIBUTION OF LOCALIZED CALCIUM DEPOSITS TO DISSECTION AFTER ANGIOPLASTY - AN OBSERVATIONAL STUDY USING INTRAVASCULAR ULTRASOUND [J].

FITZGERALD, PJ ;

PORTS, TA ;

YOCK, PG .

CIRCULATION, 1992, 86 (01) :64-70

← 1 2 →