Journal ArticleDOI
Fractional flow reserve versus angiography for guiding percutaneous coronary intervention
Bernard De Bruyne,Uwe Siebert,Fumiaki Ikeno,Volker Klauss,Ganesh Manoharan,Thomas Engstrøm,Keith G. Oldroyd,Peter N. Ver Lee,Philip MacCarthy,William F. Fearon +9 more
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Routine measurement of FFR in patients with multivessel coronary artery disease who are undergoing PCI with drug-eluting stents significantly reduces the rate of the composite end point of death, nonfatal myocardial infarction, and repeat revascularization at 1 year.Abstract:
Background In patients with multivessel coronary artery disease who are undergoing percutaneous coronary intervention (PCI), coronary angiography is the standard method for guiding the placement of the stent. It is unclear whether routine measurement of fractional flow reserve (FFR; the ratio of maximal blood flow in a stenotic artery to normal maximal flow), in addition to angiography, improves outcomes. Methods In 20 medical centers in the United States and Europe, we randomly assigned 1005 patients with multivessel coronary artery disease to undergo PCI with implantation of drug-eluting stents guided by angiography alone or guided by FFR measurements in addition to angiography. Before randomization, lesions requiring PCI were identified on the basis of their angiographic appearance. Patients assigned to angiography-guided PCI underwent stenting of all indicated lesions, whereas those assigned to FFR-guided PCI underwent stenting of indicated lesions only if the FFR was 0.80 or less. The primary end point was the rate of death, nonfatal myocardial infarction, and repeat revascularization at 1 year. Results The mean (±SD) number of indicated lesions per patient was 2.7±0.9 in the angiography group and 2.8±1.0 in the FFR group (P = 0.34). The number of stents used per patient was 2.7±1.2 and 1.9±1.3, respectively (P<0.001). The 1-year event rate was 18.3% (91 patients) in the angiography group and 13.2% (67 patients) in the FFR group (P = 0.02). Seventy-eight percent of the patients in the angiography group were free from angina at 1 year, as compared with 81% of patients in the FFR group (P = 0.20). Conclusions Routine measurement of FFR in patients with multivessel coronary artery disease who are undergoing PCI with drug-eluting stents significantly reduces the rate of the composite end point of death, nonfatal myocardial infarction, and repeat revascularization at 1 year. (ClinicalTrials.gov number, NCT00267774.)read more
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2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)
Marco Roffi,Carlo Patrono,Jean-Philippe Collet,Christian Mueller,Marco Valgimigli,Felicita Andreotti,Jeroen J. Bax,Michael A. Borger,Carlos Brotons,Derek P. Chew,Baris Gencer,Gerd Hasenfuss,Keld Kjeldsen,Patrizio Lancellotti,Ulf Landmesser,Julinda Mehilli,Debabrata Mukherjee,Robert F. Storey,Stephan Windecker +18 more
TL;DR: The current guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation are based on the findings of the ESC Task Force on 12 March 2015.
Journal ArticleDOI
ESC Guidelines for the Diagnosis And Treatment of Acute And Chronic Heart Failure 2008
Kenneth Dickstein,Alain Cohen-Solal,Gerasimos Filippatos,John J.V. McMurray,Piotr Ponikowski,Philip A. Poole-Wilson,Anna Strömberg,Dirk J. van Veldhuisen,Dan Atar,Arno W. Hoes,Andre Keren,Alexandre Mebazaa,Markku S. Nieminen,Silvia G. Priori,Karl Swedberg +14 more
TL;DR: Authors/Task Force Members: John J. McMurray (Chairperson) (UK), Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Angelo Auricchio (Switzerland), Michael Böhm ( Germany), Kenneth Dickstein (Norway), Volkmar Falk (Sw Switzerland), Gerasimos Filippatos (G Greece), Cândida Fonseca (Portugal), Miguel Angel Gomez-Sanchez (Spain).
Journal ArticleDOI
CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials
David Moher,Sally Hopewell,Kenneth F. Schulz,Victor M. Montori,Peter C Gøtzsche,Philip J. Devereaux,Diana Elbourne,Matthias Egger,Douglas G. Altman +8 more
TL;DR: This update of the CONSORT statement improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition, such as selective outcome reporting bias.
Journal ArticleDOI
ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC.
S. Adamopoulos,Stefan D. Anker,Volkmar Falk,Lars Køber,Aldo P. Maggioni,Alexander Parkhomenko,Burkert Pieske,Bogdan A. Popescu,Frans H. Rutten,Juerg Schwitter,Pedro T. Trindade,Adriaan A. Voors,Andreas M. Zeiher +12 more
TL;DR: ESC guidelines for the diagnosis and treatment of acute and chronic heart failure have been developed in collaboration with the Heart Failure Association (HFA) of the ESC 2012 Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 as mentioned in this paper.
Journal ArticleDOI
2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction
Patrick T. O'Gara,Frederick G. Kushner,Deborah D. Ascheim,Donald E. Casey,Mina K. Chung,James A. de Lemos,Steven M. Ettinger,James C. Fang,Francis M. Fesmire,Barry A. Franklin,Christopher B. Granger,Harlan M. Krumholz,Jane A. Linderbaum,David A. Morrow,L. Kristin Newby,Joseph P. Ornato,Narith N. Ou,Martha J. Radford,Jacqueline E. Tamis-Holland,Carl L. Tommaso,Cynthia M. Tracy,Y. Joseph Woo,David Zhao +22 more
TL;DR: The 2017-18 FAHA/FACC/FAHA Education and Research Grants will be focused on advancing the profession’s understanding of central nervous system disorders and the management of post-traumatic stress disorder.
References
More filters
Journal Article
EuroQol : a new facility for the measurement of health-related quality of life
Journal ArticleDOI
EQ-5D: a measure of health status from the EuroQol Group.
Rosalind Rabin,Frank de Charro +1 more
TL;DR: EQ-5D, a generic measure of health status that provides a simple descriptive profile and a single index value that can be used in the clinical and economic evaluation of health care and in population health surveys, is being widely used by clinical researchers in a variety of clinical areas.
Journal ArticleDOI
Optimal Medical Therapy with or without PCI for Stable Coronary Disease
William E. Boden,Koon K. Teo,Pamela M. Hartigan,David J. Maron,William J. Kostuk,Merril L. Knudtson,Marcin Dada,Paul Casperson,Crystal L. Harris,Bernard R. Chaitman,Leslee J. Shaw,Gilbert Gosselin,Shah Nawaz,Lawrence M. Title,Gerald T. Gau,Alvin Blaustein,David C. Booth,Eric R. Bates,John A. Spertus,Daniel S. Berman,William S. Weintraub +20 more
TL;DR: As an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy.
Journal ArticleDOI
Measurement of Fractional Flow Reserve to Assess the Functional Severity of Coronary-Artery Stenoses
Nico H.J. Pijls,Bernard De Bruyne,Kathinka H. Peels,Pepijn H. van der Voort,Hans Bonnier,Jozef Bartunek,Jacques J. Koolen +6 more
TL;DR: In patients with coronary stenosis of moderate severity, FFR appears to be a useful index of the functional severity of the stenoses and the need for coronary revascularization.
Journal Article
The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease.
Georgios Sianos,Marie Angèle Morel,Arie-Pieter Kappetein,Marie Claude Morice,Antonio Colombo,Keith D. Dawkins,van den Brand M,Van Dyck N,Mary E. Russell,Friedrich-Wilhelm Mohr,Patrick W. Serruys +10 more
TL;DR: This poster presents a probabilistic procedure called “Cardialysis BV, Rotterdam, The Netherlands”, which aims to establish a baseline for the use of this procedure in the treatment of chronic kidney disease.
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