Coronary revascularization: Difference between revisions
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| bgcolor="lightgreen"| [[CABG]] is preferred over [[PCI]] in [[patients]] with multivessel [[coronary artery disease]] who are not able to be adherent to [[dual antiplatelet therapy]]. | | bgcolor="lightgreen"| [[CABG]] is preferred over [[PCI]] in [[patients]] with multivessel [[coronary artery disease]] who are not able to be adherent to [[dual antiplatelet therapy]]. | ||
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*Being adherent to [[dual antiplatelet therapy]] is vital after [[PCI]] and non-adherence is related to [[stent]] [[thrombosis]] | *Being adherent to [[dual antiplatelet therapy]] is vital after [[PCI]] and non-adherence is related to [[stent]] [[thrombosis]], poor outcomes and high [[mortality rate]]. Therefore, [[PCA]] is not recommended in [[patients]] who can not access, tolerate, or adhere to [[dual antiplatelet therapy]].<ref name="pmid23415513">{{cite journal| author=Almalla M, Schröder J, Hennings V, Marx N, Hoffmann R| title=Long-term outcome after angiographically proven coronary stent thrombosis. | journal=Am J Cardiol | year= 2013 | volume= 111 | issue= 9 | pages= 1289-94 | pmid=23415513 | doi=10.1016/j.amjcard.2013.01.268 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23415513 }} </ref><ref name="pmid26415600">{{cite journal| author=Brodie BR, Garg A, Stuckey TD, Kirtane AJ, Witzenbichler B, Maehara A | display-authors=etal| title=Fixed and Modifiable Correlates of Drug-Eluting Stent Thrombosis From a Large All-Comers Registry: Insights From ADAPT-DES. | journal=Circ Cardiovasc Interv | year= 2015 | volume= 8 | issue= 10 | pages= | pmid=26415600 | doi=10.1161/CIRCINTERVENTIONS.114.002568 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26415600 }} </ref><ref name="pmid25703885">{{cite journal| author=Cutlip DE, Kereiakes DJ, Mauri L, Stoler R, Dauerman HL, EDUCATE Investigators| title=Thrombotic complications associated with early and late nonadherence to dual antiplatelet therapy. | journal=JACC Cardiovasc Interv | year= 2015 | volume= 8 | issue= 3 | pages= 404-410 | pmid=25703885 | doi=10.1016/j.jcin.2014.10.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25703885 }} </ref> | ||
==Outcome== | ==Outcome== |
Revision as of 08:17, 1 June 2022
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Overview
Historical Perspective
Classification
Coronary revascularization may refer to;
Indications
- Treatment decisions regarding coronary revascularization should be done regardless of sex, race, and ethnicity.[1]
- Decision regarding coronary revascularization should be patient-centered, meaning that physicians should consider patient's wishes, health literacy, and cultural believes.[1]
- Based on ACC/AHA/SCAI 2021 guideline, for patients with unclear optimal treatment strategy a Heart Team including an interventional cardiologist, cardiac surgeon, and clinical cardiologist is recommended to assess the patient's outcome. The following table demonstrates factors that can be considered by the Heart Team:[1]
Coronary Anatomy | *Left main disease *Multivessel disease *Complicated anatomy (such as bifurcation disease, and high SYNTAX score |
---|---|
Comorbidities | *Coagulopathy *Frailty *Diabetes *Valvular heart disease *Cancer *Systolic dysfunction *End-stage renal disease *Aortic aneurysm *Calcified aorta *Immunosuppression *Chronic obstructive pulmonary disease *History of cerebral stroke *Debilitating neurological disorders *Cirrhosis/liver disease |
Procedure | *Access site for percutaneous coronary intervention (PCI) *Risk of surgery *Local and regional clinical outcomes *Risk of percutaneous coronary intervention (PCI) |
Patient | *Patient preferences, religional believes, education, and knowledge *Incompliant to dual antiplatelet therapy *Patient social supports *Unstable presentation or shock |
Coronary Anatomy
- Based on ACC 2021 guideline, coronary angiography is still the default method to determine coronary anatomy and stenosis degree.[1]
- Significant stenosis is one of the indications for the revascularization procedure, which has been defined as the following observations in coronary angiography:[1]
- The fact that whether visually estimated diameter stenosis or quantitative coronary angiography can better predict the the functional significance of a coronary stenosis is controversial. [2]
- Although the lesion's length can affect the ischemia severity, there are no standard cutoffs for length of the lesions when sever stenosis is determined.
Coronary Revascularization Comparison to Medical Therapy
- Based on MASS II (Medicine, Angioplasty, or Surgery Study), CABG or PCI cohorts had lower 10-year mortality rate compared to those who received medical therapy.[3] This was further supported by a meta-analysis of 25 studies with overall 19,806 participants.[4]
- In contarst, there are some other studies that did not report any differences between the mortality rate of patients who was treated with medications to those who received a revascularization procedure.[1]
- While coronary revascularization could be related to the increased incidence of procedural type 4a or type 5 MIs, it was able to decrease the incidence of late MI (spontaneous MI [type 1], demand-induced MI [type 2], or MIs associated with stent thrombosis [type 4b] or with restenosis [type 4c]) when compared to medical therapy alone.[1][4]
- In contrast, a meta-analysis done on patients with stable ischemic heart disease did not report reduction in incidence of MI after coronary revascularization, while another study demonstrated reduction in the rate of MI with CABG, but not with PCI. [5][6]
- Although medical therapy is effective in reduction of patients' symptoms, numerous studies demonstrated that coronary revascularization is more effective in improving angina and quality of life compared to medical therapy alone.[7][8][9][10][11][12]
What Procedure to Choose?
- Although many indications are the same for performing either PCI or CABG, these two procedures have inherently different mechanisms.[1]
- Most studies report a same outcome with PCI and CABG, but there are some reports that favor CABG over PCI:
- The SYNTAX trial with 705 patients demonstrated a significantly higher rate of major adverse cardiovascular events and mortality rate among those who received PCI than the CABG cohort.[13]
- Two Studies reported that CABG is more effective in prevention of late spontaneous MI when compared to PCI.[14][15]
- ACA 2021 revascularization guideline recommends to consider the following factors to decide whether to chose PCI or CABG:[1]
- SYNTAX Score[16]
- SYNTAX score derived from a clinical trial with the same name which predicts the grade of the anatomic complexity and can be used as a decision-making tool.
- This score is a guide for selection of a revascularization procedure in patients with multivessel coronary artery disease.
- All cause mortality rate among patients with a coronary artery disease-associated SYNTAX score equal or greater than 33 were significantly lower when undergone CABG than PCI
- For patients with SYNTAX score lower than 33, no differences have been report in mortality rate of CABG and PCI
- Compliance to medications
- Preferences of patient
- Individual factors, such as anatomic complexity, which is discussed in the following table:[1]
- SYNTAX Score[16]
Multivessel disease |
---|
Left main or proximal left anterior descending artery lesion |
Chronic total occlusion |
Trifurcation lesion |
Complex bifurcation lesion |
Heavy calcification |
Severe tortuosity |
Aorto-ostial stenosis |
Diffusely diseased and narrowed segments distal to the lesion |
Thrombotic lesion |
Lesion length >20 mm |
- PCI would help patients with STEMI and ischemic symptoms for less than 12 hours.[1]
- Rescue PCI is recommended for STEMI patients who failed re-perfusion after fibrinolytic therapy to improve the survival.[17][18][19]
- PCI has been related to improved survival rate when done in STEMI patients who are stable and presented 12 to 24 hours after symptom onset.[20]
- Regardless of time from MI, PCI can increase survival in STEMI patients who developed complications such as ongoing ischemia, acute sever heart failure, or life-threatening cardiac arrhythmia.[1]
- Performing the PCI is not beneficial in stable and asymptomatic STEMI patients who have a totally occluded infarct artery >24 hours after symptom onset with no evidence for sever ischemia.[1]
- The role of PCI in asymptomatic STEMI patients who are presenting after 12 to 24 hours after symptom onset is not well studied.[1]
- Both PCI and CABG are indicated in patients with STEMI, cardiogenic shock, and hemodynamic instability.[22]
- CABG is recommended for patients with STEMI who have mechanical complications such as ventricular septal rupture, mitral regurgitation because of papillary muscle infarction or rupture, or free wall rupture.[1]
- Emergent or urgent CABG is recommended in STEMI patients whose PCI is not feasible with a large area of myocardial involvement. On the other hand, emergent or urgent CABG should be avoided in these patients in the absence of ischemia or large myocardial involvement. Furthermore, CABG is usually avoided if patients' distal targets are poor.[1][23]
- The following algorithm demonstrates the proper revascularization in STEMI patients.[1]
STEMI/Ischemia symptoms | |||||||||||||||||||||||||||||||||||||||||||||||||||
Symptoms started started less than 12 hours | Symptoms started equal or more than 12 hours | ||||||||||||||||||||||||||||||||||||||||||||||||||
Is PCI feasible? | Cardiogenic shock or heart failure | Ongoing ischemia? Heart failure? Electrolyte disturbance? | Onset of symptoms within 12-24 hours? | Totally occluded artery for longer than 24 hours without symptoms or ischemia | |||||||||||||||||||||||||||||||||||||||||||||||
Yes | No | Is PCI feasible? | Yes | Yes | Yes | ||||||||||||||||||||||||||||||||||||||||||||||
Primary PCI | CABG (if large area of myocardium is involved) | Primary PCI | PCI | No benefit in PCI | |||||||||||||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||
Primary PCI | CABG | ||||||||||||||||||||||||||||||||||||||||||||||||||
- The sole condition that fibrinolytic therapies are superior to PCI is when the duration from hospital presentation to PCI is anticipated to be more than 120 minutes.
- An early revascularization strategy could increase the survival rate in patients with STEMI complicated by cardiogenic shock.
Fractional flow reserve and instantaneous wave-Free Ratio
- Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are commonly used to assess the lesion significant. Fractional flow reserve (FFR) compares the maximal blood flow distal to the lesion to the normal maximal blood flow. On the other hand iFR compares the instantaneous wave-free ratio of the coronary pressure distal to the lesion during the diastole with the aortic pressure.[1]
- Reported in numbers of trials which used FFR, FFR-guided PCI was successful in lowering the revascularization rate, procedure-related chest pain in patients with stable coronary artery disease and functionally significant stenosis.[24][25][26]
- In one of these trials patients with abnormal FFR significantly benefited from PCI over medical therapy with lower rate of ischemia-driven revascularization and shorter procedural time. [27]
- FFR-guided revascularization with CABG was more off-pump with fewer anastomosis and simpler procedure compared to CABG with angiogram-guided revascularization in one of the clinical trials.[28][1][29] Although other studies reported similar outcomes in both.[30][31]
- iFR measure does not require the administration of adenosine has been also studied in clinical trials. Results supported that this measure is not inferior to FFR and also showed less adverse outcome related to the procedure.[32]
- Lower rate of long-term major adverse cardiac events has been reported when PCI was deferred with FFR greater than 0.80 or iFR that is >0.89. One of the trials named DEFER (Deferral of Percutaneous Intervention) reported that the rate of adverse outcome cardiac outcomes is similar in both group of patients whose PCI has been deferred either with a FFR greater than 0.75 or intermediate angiographic measures.[33][34][35]
ACA 2021 Guidline Recommendations for Specific Patients
Diabetics
Class One Recommendation, Level of Evidence: A[1] |
CABG with a LIMA to the LAD can reduce mortality and repeat revascularizations compared with PCI in diabetic patients who have multivessel coronary artery disease with LAD involvement and are appropriate candidates. |
Class 2a Recommendation, Level of Evidence: B-NR [1] |
PCI can be chosen to reduce long-term ischemic outcomes in diabetic patients with multivessel coronary artery disease and poor surgery candidacy (only when there is an indication for revascularization and patient preferences are considered. |
Class 2b Recommendation, Level of Evidence: B-R [1] |
PCI can decrease major adverse cardiovascular outcomes as an alternative to CABG in diabetic patients who have LAD stenosis and low to intermediate CAD complexity in other arteries. |
- The following should be considered when making revascularization decision for diabetic patient:[1]
- Using Heart Team approach
- Patient preferences
- Left ventricular function
- Other comorbidities
- Ongoing symptoms
- Expected survival
- Diabetic patients experience a higher rate of mortality and repeat revascularization when undergone revascularization.[36]
- PCI has been associated with a higher five-year-mortality rate compared to CABG. [37]
- Two years after CABG the survival advantages become edivent and it will decrease after 8 years.[38]
- CABG is related to an overall increase in likelihood of stroke for five years.[39]
- Need of repeated revascularization is higher in PCA compared to CABG regardless of the use of the new generation of drug eluting stent.[1]
Patients with Previous CABG
Class 2a Recommendation, Level of Evidence: B-NR[1] |
PCI is preferred over CABG in a patient with a previous CABG history and a patent internal thoracic artery (LIMA) to LAD who requires revascularization again (only if feasible). |
Class 2a Recommendation, Level of Evidence: C-LD[1] |
CABG is preferred in a patient with a previous CABG history and refractory angina that is attributable to LAD disease when the internal mammary artery can be used. |
Class 2b Recommendation, Level of Evidence: B-NR[1] |
CABG is preferred in a patient with a previous CABG history and complex coronary artery disease when the internal mammary artery can be used. |
- The following factors should be considered when repeated revascularization is required:[1]
- Internal mammary artery accessibilty
- A patent graft to the LAD
- Other comorbidities
- Patient's preferences
- The quality of the target vessel
- Anatomic complexity
- Feasibilty of the revascularization procedure
- Risks of the revascularization procedure
Non Adherence to Dual Antiplatelet Therapy
Class 2a Recommendation, Level of Evidence: B-NR[1] |
CABG is preferred over PCI in patients with multivessel coronary artery disease who are not able to be adherent to dual antiplatelet therapy. |
- Being adherent to dual antiplatelet therapy is vital after PCI and non-adherence is related to stent thrombosis, poor outcomes and high mortality rate. Therefore, PCA is not recommended in patients who can not access, tolerate, or adhere to dual antiplatelet therapy.[40][41][42]
Outcome
- After controlling baseline comorbidities and treatment strategies, outcome of coronary revascularization were same among different races as well as males and females.[1][43][44]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM; et al. (2022). "2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". J Am Coll Cardiol. 79 (2): e21–e129. doi:10.1016/j.jacc.2021.09.006. PMID 34895950 Check
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value (help). - ↑ Adjedj J, Xaplanteris P, Toth G, Ferrara A, Pellicano M, Ciccarelli G; et al. (2017). "Visual and Quantitative Assessment of Coronary Stenoses at Angiography Versus Fractional Flow Reserve: The Impact of Risk Factors". Circ Cardiovasc Imaging. 10 (7). doi:10.1161/CIRCIMAGING.117.006243. PMID 28687539.
- ↑ Hueb W, Lopes N, Gersh BJ, Soares PR, Ribeiro EE, Pereira AC; et al. (2010). "Ten-year follow-up survival of the Medicine, Angioplasty, or Surgery Study (MASS II): a randomized controlled clinical trial of 3 therapeutic strategies for multivessel coronary artery disease". Circulation. 122 (10): 949–57. doi:10.1161/CIRCULATIONAHA.109.911669. PMID 20733102. Review in: Evid Based Med. 2011 Apr;16(2):50-1
- ↑ 4.0 4.1 Navarese EP, Lansky AJ, Kereiakes DJ, Kubica J, Gurbel PA, Gorog DA; et al. (2021). "Cardiac mortality in patients randomised to elective coronary revascularisation plus medical therapy or medical therapy alone: a systematic review and meta-analysis". Eur Heart J. 42 (45): 4638–4651. doi:10.1093/eurheartj/ehab246. PMC 8669551 Check
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value (help). PMID 34002203 Check|pmid=
value (help). - ↑ Windecker S, Stortecky S, Stefanini GG, da Costa BR, daCosta BR, Rutjes AW; et al. (2014). "Revascularisation versus medical treatment in patients with stable coronary artery disease: network meta-analysis". BMJ. 348: g3859. doi:10.1136/bmj.g3859. PMC 4066935. PMID 24958153. Review in: Ann Intern Med. 2014 Oct 21;161(8):JC10
- ↑ Chacko L, P Howard J, Rajkumar C, Nowbar AN, Kane C, Mahdi D; et al. (2020). "Effects of Percutaneous Coronary Intervention on Death and Myocardial Infarction Stratified by Stable and Unstable Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials". Circ Cardiovasc Qual Outcomes. 13 (2): e006363. doi:10.1161/CIRCOUTCOMES.119.006363. PMC 7034389 Check
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value (help). PMID 32063040 Check|pmid=
value (help). - ↑ Spertus JA, Jones PG, Maron DJ, O'Brien SM, Reynolds HR, Rosenberg Y; et al. (2020). "Health-Status Outcomes with Invasive or Conservative Care in Coronary Disease". N Engl J Med. 382 (15): 1408–1419. doi:10.1056/NEJMoa1916370. PMC 7261489 Check
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value (help). PMID 32227753 Check|pmid=
value (help). Review in: Ann Intern Med. 2020 Aug 18;173(4):JC15 - ↑ Nishigaki K, Yamazaki T, Kitabatake A, Yamaguchi T, Kanmatsuse K, Kodama I; et al. (2008). "Percutaneous coronary intervention plus medical therapy reduces the incidence of acute coronary syndrome more effectively than initial medical therapy only among patients with low-risk coronary artery disease a randomized, comparative, multicenter study". JACC Cardiovasc Interv. 1 (5): 469–79. doi:10.1016/j.jcin.2008.08.002. PMID 19463347.
- ↑ Fearon WF, Nishi T, De Bruyne B, Boothroyd DB, Barbato E, Tonino P; et al. (2018). "Clinical Outcomes and Cost-Effectiveness of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention in Patients With Stable Coronary Artery Disease: Three-Year Follow-Up of the FAME 2 Trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation)". Circulation. 137 (5): 480–487. doi:10.1161/CIRCULATIONAHA.117.031907. PMID 29097450.
- ↑ Abdallah MS, Wang K, Magnuson EA, Spertus JA, Farkouh ME, Fuster V; et al. (2013). "Quality of life after PCI vs CABG among patients with diabetes and multivessel coronary artery disease: a randomized clinical trial". JAMA. 310 (15): 1581–90. doi:10.1001/jama.2013.279208. PMC 4370776. PMID 24129463.
- ↑ Baron SJ, Chinnakondepalli K, Magnuson EA, Kandzari DE, Puskas JD, Ben-Yehuda O; et al. (2017). "Quality-of-Life After Everolimus-Eluting Stents or Bypass Surgery for Left-Main Disease: Results From the EXCEL Trial". J Am Coll Cardiol. 70 (25): 3113–3122. doi:10.1016/j.jacc.2017.10.036. PMID 29097293.
- ↑ Brooks MM, Chung SC, Helmy T, Hillegass WB, Escobedo J, Melsop KA; et al. (2010). "Health status after treatment for coronary artery disease and type 2 diabetes mellitus in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial". Circulation. 122 (17): 1690–9. doi:10.1161/CIRCULATIONAHA.109.912642. PMC 2964421. PMID 20937978.
- ↑ Morice MC, Serruys PW, Kappetein AP, Feldman TE, Ståhle E, Colombo A; et al. (2014). "Five-year outcomes in patients with left main disease treated with either percutaneous coronary intervention or coronary artery bypass grafting in the synergy between percutaneous coronary intervention with taxus and cardiac surgery trial". Circulation. 129 (23): 2388–94. doi:10.1161/CIRCULATIONAHA.113.006689. PMID 24700706.
- ↑ Gallo M, Blitzer D, Laforgia PL, Doulamis IP, Perrin N, Bortolussi G; et al. (2022). "Percutaneous coronary intervention versus coronary artery bypass graft for left main coronary artery disease: A meta-analysis". J Thorac Cardiovasc Surg. 163 (1): 94–105.e15. doi:10.1016/j.jtcvs.2020.04.010. PMID 32499076 Check
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value (help). - ↑ Boudriot E, Thiele H, Walther T, Liebetrau C, Boeckstegers P, Pohl T; et al. (2011). "Randomized comparison of percutaneous coronary intervention with sirolimus-eluting stents versus coronary artery bypass grafting in unprotected left main stem stenosis". J Am Coll Cardiol. 57 (5): 538–45. doi:10.1016/j.jacc.2010.09.038. PMID 21272743.
- ↑ Garg S, Serruys PW, Silber S, Wykrzykowska J, van Geuns RJ, Richardt G; et al. (2011). "The prognostic utility of the SYNTAX score on 1-year outcomes after revascularization with zotarolimus- and everolimus-eluting stents: a substudy of the RESOLUTE All Comers Trial". JACC Cardiovasc Interv. 4 (4): 432–41. doi:10.1016/j.jcin.2011.01.008. PMID 21511223.
- ↑ Sutton AG, Campbell PG, Graham R, Price DJ, Gray JC, Grech ED; et al. (2004). "A randomized trial of rescue angioplasty versus a conservative approach for failed fibrinolysis in ST-segment elevation myocardial infarction: the Middlesbrough Early Revascularization to Limit INfarction (MERLIN) trial". J Am Coll Cardiol. 44 (2): 287–96. doi:10.1016/j.jacc.2003.12.059. PMID 15261920.
- ↑ Collet JP, Montalescot G, Le May M, Borentain M, Gershlick A (2006). "Percutaneous coronary intervention after fibrinolysis: a multiple meta-analyses approach according to the type of strategy". J Am Coll Cardiol. 48 (7): 1326–35. doi:10.1016/j.jacc.2006.03.064. PMID 17010790.
- ↑ Madan M, Halvorsen S, Di Mario C, Tan M, Westerhout CM, Cantor WJ; et al. (2015). "Relationship between time to invasive assessment and clinical outcomes of patients undergoing an early invasive strategy after fibrinolysis for ST-segment elevation myocardial infarction: a patient-level analysis of the randomized early routine invasive clinical trials". JACC Cardiovasc Interv. 8 (1 Pt B): 166–174. doi:10.1016/j.jcin.2014.09.005. PMID 25616922.
- ↑ Schömig A, Mehilli J, Antoniucci D, Ndrepepa G, Markwardt C, Di Pede F; et al. (2005). "Mechanical reperfusion in patients with acute myocardial infarction presenting more than 12 hours from symptom onset: a randomized controlled trial". JAMA. 293 (23): 2865–72. doi:10.1001/jama.293.23.2865. PMID 15956631.
- ↑ Fox KA, Clayton TC, Damman P, Pocock SJ, de Winter RJ, Tijssen JG; et al. (2010). "Long-term outcome of a routine versus selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome a meta-analysis of individual patient data". J Am Coll Cardiol. 55 (22): 2435–45. doi:10.1016/j.jacc.2010.03.007. PMID 20359842.
- ↑ Mehta RH, Lopes RD, Ballotta A, Frigiola A, Sketch MH, Bossone E; et al. (2010). "Percutaneous coronary intervention or coronary artery bypass surgery for cardiogenic shock and multivessel coronary artery disease?". Am Heart J. 159 (1): 141–7. doi:10.1016/j.ahj.2009.10.035. PMID 20102880.
- ↑ Pi Y, Roe MT, Holmes DN, Chiswell K, Garvey JL, Fonarow GC; et al. (2017). "Utilization, Characteristics, and In-Hospital Outcomes of Coronary Artery Bypass Grafting in Patients With ST-Segment-Elevation Myocardial Infarction: Results From the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines". Circ Cardiovasc Qual Outcomes. 10 (8). doi:10.1161/CIRCOUTCOMES.116.003490. PMID 28794118.
- ↑ De Bruyne B, Pijls NH, Kalesan B, Barbato E, Tonino PA, Piroth Z; et al. (2012). "Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease". N Engl J Med. 367 (11): 991–1001. doi:10.1056/NEJMoa1205361. PMID 22924638.
- ↑ De Bruyne B, Fearon WF, Pijls NH, Barbato E, Tonino P, Piroth Z; et al. (2014). "Fractional flow reserve-guided PCI for stable coronary artery disease". N Engl J Med. 371 (13): 1208–17. doi:10.1056/NEJMoa1408758. PMID 25176289.
- ↑ Xaplanteris P, Fournier S, Pijls NHJ, Fearon WF, Barbato E, Tonino PAL; et al. (2018). "Five-Year Outcomes with PCI Guided by Fractional Flow Reserve". N Engl J Med. 379 (3): 250–259. doi:10.1056/NEJMoa1803538. PMID 29785878.
- ↑ Kang SJ, Lee JY, Ahn JM, Song HG, Kim WJ, Park DW; et al. (2011). "Intravascular ultrasound-derived predictors for fractional flow reserve in intermediate left main disease". JACC Cardiovasc Interv. 4 (11): 1168–74. doi:10.1016/j.jcin.2011.08.009. PMID 22115656.
- ↑ Bruno F, D'Ascenzo F, Marengo G, Manfredi R, Saglietto A, Gallone G; et al. (2021). "Fractional flow reserve guided versus angiographic guided surgical revascularization: A meta-analysis". Catheter Cardiovasc Interv. 98 (1): E18–E23. doi:10.1002/ccd.29427. PMID 33315297 Check
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value (help). - ↑ Toth GG, De Bruyne B, Kala P, Ribichini FL, Casselman F, Ramos R; et al. (2019). "Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial". EuroIntervention. 15 (11): e999–e1005. doi:10.4244/EIJ-D-19-00463. PMID 31270037.
- ↑ Timbadia D, Ler A, Sazzad F, Alexiou C, Kofidis T (2020). "FFR-guided versus coronary angiogram-guided CABG: A review and meta-analysis of prospective randomized controlled trials". J Card Surg. 35 (10): 2785–2793. doi:10.1111/jocs.14880. PMID 32697006 Check
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value (help). - ↑ Thuesen AL, Riber LP, Veien KT, Christiansen EH, Jensen SE, Modrau I; et al. (2018). "Fractional Flow Reserve Versus Angiographically-Guided Coronary Artery Bypass Grafting". J Am Coll Cardiol. 72 (22): 2732–2743. doi:10.1016/j.jacc.2018.09.043. PMID 30497559.
- ↑ Bruner CA, Webb RC (1990). "Increased vascular reactivity to Bay K 8644 in genetic hypertension". Pharmacology. 41 (1): 24–35. doi:10.1159/000138696. PMID 0.1056/NEJMoa1700445 Check
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value (help). - ↑ Pijls NH, van Schaardenburgh P, Manoharan G, Boersma E, Bech JW, van't Veer M; et al. (2007). "Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study". J Am Coll Cardiol. 49 (21): 2105–11. doi:10.1016/j.jacc.2007.01.087. PMID 17531660.
- ↑ Pijls NH, Fearon WF, Tonino PA, Siebert U, Ikeno F, Bornschein B; et al. (2010). "Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study". J Am Coll Cardiol. 56 (3): 177–84. doi:10.1016/j.jacc.2010.04.012. PMID 20537493.
- ↑ Escaned J, Ryan N, Mejía-Rentería H, Cook CM, Dehbi HM, Alegria-Barrero E; et al. (2018). "Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes". JACC Cardiovasc Interv. 11 (15): 1437–1449. doi:10.1016/j.jcin.2018.05.029. PMID 30093050.
- ↑ Armstrong EJ, Rutledge JC, Rogers JH (2013). "Coronary artery revascularization in patients with diabetes mellitus". Circulation. 128 (15): 1675–85. doi:10.1161/CIRCULATIONAHA.113.002114. PMC 3901842. PMID 24100481.
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|pmc=
value (help). PMID 30428398. - ↑ Head SJ, Milojevic M, Daemen J, Ahn JM, Boersma E, Christiansen EH; et al. (2018). "Stroke Rates Following Surgical Versus Percutaneous Coronary Revascularization". J Am Coll Cardiol. 72 (4): 386–398. doi:10.1016/j.jacc.2018.04.071. PMID 30025574. Review in: Ann Intern Med. 2018 Nov 20;169(10):JC55
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