Long-term safety of intracoronary haemodynamic assessment for deferral of angioplasty in intermediate coronary stenoses: a 5-year follow-up.
BACKGROUND
Intracoronary flow and pressure measurements can be used for evaluating intermediate lesions. Studies focussing on short- and medium-term results demonstrated its safety. Long-term results are, however, not available.


OBJECTIVE
The goal of this study was to assess the long-term safety and clinical implications of decision making for intermediate coronary stenosis based on intra-coronary haemodynamic measurements.


RESULTS
In this prospective study, 61 patients with an intermediate coronary stenosis were included between January 1994 and December 1998. In these patients either coronary flow reserve or fractional flow reserve was measured. Death, target vessel revascularization, myocardial infarction, unstable angina and cerebrovascular accident were considered as major adverse cardiac events. The patients were followed during 5.5 (1.8) years for the occurrence of major adverse cardiac events (MACE). Although many patients presented with complaints, only 19.7% experienced a MACE in the follow-up period.


CONCLUSIONS
Intracoronary measurements of CFR and FFR can be routinely used for objective clinical decision making in intermediate coronary stenoses. The low 5-year event rate supports conservative treatment strategy when cut-off values are implemented.
Wijpkema
Jasper S
JS
Department of Cardiology, University Medical Center Groningen, The Netherlands. jasper@wijpkema.nl
Van der Vleuten
Pieter A
PA
Jessurun
Gillian A J
GA
Tio
René A
RA
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023921:Coronary Stenosis / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow