Clinical Implication of 3-vessel Fractional Flow Reserve (FFR)

Conditions

Multivessel Coronary Artery Disease

Keywords

coronary artery, atherosclerosis, angina pectoris

Brief summary

This study will evaluate the influence of total atherosclerotic burden assessed by 3-vessel fractional flow reserve (FFR) on the clinical outcomes of the patients with multi-vessel disease. For this purpose, the clinical data of the patients with 3-vessel intermediate coronary artery disease, whose FFR was measured at all 3-vessels due to their own clinical needs, will be analyzed.

Detailed description

Primary Analysis The Primary Analysis will be performed after 2-year follow-up data will be completed. Pre-specified Subgroup Analysis The pre-specified subgroup analysis will perform after 1-year follow-up data will be completed according to the following subjects: * Concordant and discordant results between FFR and angiographic stenosis severity (patients and lesions with pre-PCI FFR will be analyzed.). * Association between total atherosclerotic burden and total ischemic burden, coronary CT angiography substudy (after 2-year follow-up will be completed). * Validation of total ischemic burden (sum of 3 vessel FFR) with Duke score, measured by treadmill test. * Comparison of clinical outcomes of deferred lesions according to pre-PCI FFR levels (Pre-PCI FFR \<0.75, 0.75-0.80, and \>0.80). * Comparison of clinical outcomes of deferred lesions according to iFR and FFR values ⑥ Prognosis of functional complete revascularization versus incomplete revascularization

Kim CH, Yang S, Zhang J, Lee JM, Hoshino M, Murai T, Hwang D, Shin ES, Doh JH, Nam CW, Wang J, Chen SL, Tanaka N, Matsuo H, Akasaka T, Kakuta T, Koo BK.

2022-03-299 citations

10.1016/j.jacasi.2021.11.011

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2021-06-1511 citations

10.1016/j.jacasi.2021.05.003

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10.1161/jaha.120.016818

Prognostic Implications of Plaque Characteristics and Stenosis Severity in Patients With Coronary Artery Disease.

Lee JM, Choi KH, Koo BK, Park J, Kim J, Hwang D, Rhee TM, Kim HY, Jung HW, Kim KJ, Yoshiaki K, Shin ES, Doh JH, Chang HJ, Cho YK, Yoon HJ, Nam CW, Hur SH, Wang J, Chen S, Kuramitsu S, Tanaka N, Matsuo H, Akasaka T.

2019-05-01146 citations

10.1016/j.jacc.2019.02.060

Influence of Sex on Relationship Between Total Anatomical and Physiologic Disease Burdens and Their Prognostic Implications in Patients With Coronary Artery Disease

Chee Hae Kim, Bon‐Kwon Koo, Joo Myung Lee, Eun‐Seok Shin, Jonghanne Park et al. (20 authors)

Journal of the American Heart Association2019-02-2813 citations

10.1161/jaha.118.011002

Physiological and Clinical Assessment of Resting Physiological Indexes

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Circulation2019-01-17116 citations

10.1161/circulationaha.118.037021

Clinical Relevance of Functionally Insignificant Moderate Coronary Artery Stenosis Assessed by 3‐Vessel Fractional Flow Reserve Measurement

Jonghanne Park, Joo Myung Lee, Bon‐Kwon Koo, Eun‐Seok Shin, Chang‐Wook Nam et al. (20 authors)

Journal of the American Heart Association2018-02-1611 citations

10.1161/jaha.117.008055

Prognostic Implication of Functional Incomplete Revascularization and Residual Functional SYNTAX Score in Patients With Coronary Artery Disease.

Choi KH, Lee JM, Koo BK, Nam CW, Shin ES, Doh JH, Rhee TM, Hwang D, Park J, Zhang J, Kim KJ, Hu X, Wang J, Ye F, Chen S, Yang J, Chen J, Tanaka N, Yokoi H, Matsuo H, Takashima H, Shiono Y, Akasaka T.

2018-01-1746 citations

10.1016/j.jcin.2017.09.009

Three-Vessel Assessment of Coronary Microvascular Dysfunction in Patients With Clinical Suspicion of Ischemia

Yuhei Kobayashi, Joo Myung Lee, William F. Fearon, Jang Hoon Lee, Takeshi Nishi et al. (13 authors)

Circulation Cardiovascular Interventions2017-11-0133 citations

10.1161/circinterventions.117.005445

Lee JM, Park J, Hwang D, Kim CH, Choi KH, Rhee TM, Tong Y, Park JJ, Shin ES, Nam CW, Doh JH, Koo BK.

2017-10-0140 citations

10.1016/j.jacc.2017.09.007

Clinical Outcomes of Deferred Lesions With Angiographically Insignificant Stenosis But Low Fractional Flow Reserve

Joo Myung Lee, Bon‐Kwon Koo, Eun‐Seok Shin, Chang‐Wook Nam, Joon‐Hyung Doh et al. (20 authors)

Journal of the American Heart Association2017-08-0220 citations

10.1161/jaha.117.006071

Clinical implications of three-vessel fractional flow reserve measurement in patients with coronary artery disease

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European Heart Journal2017-07-20100 citations

10.1093/eurheartj/ehx458

Integrated Myocardial Perfusion Imaging Diagnostics Improve Detection of Functionally Significant Coronary Artery Stenosis by <sup>13</sup> N-ammonia Positron Emission Tomography

Joo Myung Lee, Chee Hae Kim, Bon‐Kwon Koo, Doyeon Hwang, Jonghanne Park et al. (16 authors)

Circulation Cardiovascular Imaging2016-09-0175 citations

10.1161/circimaging.116.004768

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Healthy volunteers

No

Inclusion criteria

* Subject must be at least 18 years of age. * Subject must have stenosis (\>30% by visual estimate) in all 3-epicardial coronary arteries. * FFR should be measured at all 3-vessels at the end of a procedure.

Exclusion criteria

* Depressed left ventricular systolic function (ejection fraction \< 35%) * ST-elevation myocardial infarction within 72 hours, * Prior coronary artery bypass graft surgery * Creatinine level \>= 2.0mg/dL or dependence on dialysis * Abnormal final myocardial flow (TIMI flow \< 3) * Planned bypass surgery * Failed FFR measurement * Failed intended revascularization

Design outcomes

Primary

Measure	Time frame
The rate of the composite of major adverse cardiac events (MACE: cardiac death, myocardial infarction, revascularization) at 2 years per 3-vessel FFR	2 years after FFR measurement

Countries

China, Japan, Singapore, South Korea, Taiwan

Outcome results