Six-month quantitative angiographic follow-up of <50% diameter stenoses dilated during multilesion percutaneous transluminal coronary angioplasty

doi:10.1016/0002-9149(93)90652-S

The American Journal of Cardiology

Volume 71, Issue 13, 15 May 1993, Pages 1226-1229

https://doi.org/10.1016/0002-9149(93)90652-S Get rights and content

Abstract

In patients who undergo percutaneous transluminal coronary angioplasty (PTCA), nonsignificant (<50% reduction in lumen diameter) stenoses frequently coexist with more severe target lesions. No study has examined the quantitative angiographic outcome when these narrowings are treated by PTCA. This study was designed to determine how often lesions with <50% luminal diameter narrowing, assessed by quantitative coronary angiography, were dilated during consecutive multivessel PTCA procedures in our institution and to determine the angiographic outcome of these dilations at 6 months.

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Citation Excerpt :
Because the study was retrospective and nonrandomized, it does not provide event rates from a control group of patients that actually underwent coronary intervention. However, extrapolating from other interventional studies, the study population had cardiac event rates of only ≃5% per year compared with 6-month event rates of 20% to 30% after balloon angioplasty and 15% after coronary stenting.73,75,101 To further validate the prognostic potential of FFR, a prospective, randomized, multicenter study called the DEFER study was performed.102
Long-term follow-up after deferral of percutaneous transluminal coronary angioplasty of intermediate stenosis on the basis of coronary pressure measurement
1998, Journal of the American College of Cardiology
Objectives. This study sought to determine the safety of deferral of percutaneous transluminal coronary angioplasty (PTCA) of angiographically intermediate but functionally nonsignificant stenosis, as assessed by coronary pressure measurement and myocardial fractional flow reserve (FFR_myo).
Background. Decision making in patients with chest pain and intermediate coronary stenosis remains difficult. In these cases it is unclear whether the risk of an intervention and the potentially subsequent restenosis outweigh the future risk of an event if the lesion remains untreated. FFR_myois a lesion-specific functional index of epicardial stenosis severity that accurately distinguishes stenoses associated with inducible ischemia.
Methods. Retrospective analysis and follow-up was performed in 100 consecutive patients referred to our centers for PTCA of an intermediate stenosis but in whom the planned intervention was deferred on the basis of an FFR_myo≥0.75.
Results. During a follow-up period of 18 ± 13 months (mean ± SD, range 3 to 42), two patients died of noncardiac causes. Ninety patients remained free of any coronary events, and their average Canadian Cardiovascular Society class decreased from 2.0 ± 1.2 at baseline to 0.7 ± 0.9 at follow-up (p < 0.0001). A coronary event occurred in eight patients and was target-vessel related in four.
Conclusions. In patients with chest pain referred for PTCA of an intermediate stenosis, deferral of the intervention on the basis of an FFR_myo≥0.75 is safe and is associated with a much lower clinical event rate than if the procedure had been performed as initially planned in these patients.
LL-37 and Its Complexes Are Useful Predictors of Coronary Artery Disease
2020, SSRN
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2015, European Heart Journal
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Brief reportSix-month quantitative angiographic follow-up of <50% diameter stenoses dilated during multilesion percutaneous transluminal coronary angioplasty

Abstract

J Am Coll Cardiol

Am J Cardiol

Am J Cardiol

J Am Coll Cardiol

J Am Coll Cardiol

Brief report
Six-month quantitative angiographic follow-up of <50% diameter stenoses dilated during multilesion percutaneous transluminal coronary angioplasty