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Cirugía Cardiaca en México

ISSN 2448-5640 (Print)
Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.
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2022, Number 3

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Cir Card Mex 2022; 7 (3)

Fractional Flow Reserve Guided PCI as Compared with Coronary Bypass Surgery. “BUT will they respect it?”

Espinoza-Hernández JD
Full text How to cite this article

Language: English
References: 7
Page: 41-42
PDF size: 128.27 Kb.


Key words:

Coronary artery bypass grafting, Coronary artery disease, Percutaneous coronary intervention.

Text Extraction

I have read the article that was recently published on New England Journal of Medicine by Fearon et al. It is a multicenter, international, noninferiority trial, in which patients with three-vessel coronary artery disease were randomly assigned to undergo Coronary Artery Bypass Graft (CABG) or Fractional Flow Reserve Guided (FFR-guided) Percutaneous Coronary Intervention (PCI) with current-generation zotarolimus-eluting stents. The primary end point was the occurrence within 1-year of a major adverse cardiac or cerebrovascular event, defined as death from any cause, myocardial infarction, stroke, or repeat revascularization. Noninferiority of FFR-guided PCI to CABG was prespecified as an upper limit of less than 1.65 for the 95% confidence interval of the hazard ratio. Secondary end points included a composite of death, myocardial infarction, or stroke; safety was also assessed.


REFERENCES

  1. Fearon WF, Zimmermann FM, De Bruyne B, et al.; FAME 3 Investigators. FractionalFlow Reserve-Guided PCI as Compared with Coronary Bypass Surgery. NEngl J Med. 2022;386(2):128-137. doi: 10.1056/NEJMoa2112299.

  2. Neumann FJ, Sousa-Uva M, Ahlsson A, et al.; ESC Scientific Document Group.2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J.2019;40(2):87-165. doi: 10.1093/eurheartj/ehy394.

  3. Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI Guidelinefor Coronary Artery Revascularization: Executive Summary: A Report of theAmerican College of Cardiology/American Heart Association Joint Committeeon Clinical Practice Guidelines. Circulation. 2022;145(3):e4-e17. doi: 10.1161/CIR.0000000000001039.

  4. Serruys PW, Morice MC, Kappetein AP, et al.; SYNTAX Investigators. Percutaneouscoronary intervention versus coronary-artery bypass grafting for severecoronary artery disease. N Engl J Med. 2009;360(10):961-972. doi: 10.1056/NEJMoa0804626.

  5. Stone GW, Kappetein AP, Sabik JF, et al. Five-year outcomes after PCI or CABGfor left main coronary disease. N Engl J Med 2019; 381:1820-1830.DOI: 10.1056/NEJMc2000645.

  6. Mäkikallio T, Holm NR, Lindsay M, et al.; NOBLE study investigators. Percutaneouscoronary angioplasty versus coronary artery bypass grafting in treatment ofunprotected left main stenosis (NOBLE): a prospective, randomised, open-label,non-inferiority trial. Lancet. 2016;388(10061):2743-2752. doi: 10.1016/S0140-6736(16)32052-9.

  7. Farkouh ME, Domanski M, Sleeper LA, et al.; FREEDOM Trial Investigators.Strategies for multivessel revascularization in patients with diabetes. N Engl JMed. 2012;367(25):2375-2384. doi: 10.1056/NEJMoa1211585.




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Cir Card Mex. 2022;7