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32 results on '"Matsuo, Hitoshi"'

1. Impact of sex on the assessment of the microvascular resistance reserve

Author: Cardiologie, Team Medisch, Circulatory Health, Boerhout, Coen K.M., Vink, C. E.M., Lee, Joo Myung, de Waard, Guus A., Mejia-Renteria, Hernan, Lee, Seung Hun, Jung, Ji Hyun, Hoshino, Masahiro, Echavarria-Pinto, Mauro, Meuwissen, Martijn, Matsuo, Hitoshi, Madera-Cambero, Maribel, Eftekhari, Ashkan, Effat, Mohamed A., Murai, Tadashi, Marques, Koen, Doh, Joon Hyung, Christiansen, Evald H., Banerjee, Rupak, Nam, Chang Wook, Niccoli, Giampaolo, Nakayama, Masafumi, Tanaka, Nobuhiro, Shin, Eun Seok, Appelman, Yolande, Beijk, Marcel A.M., van Royen, Niels, Chamuleau, Steven A.J., Knaapen, Paul, Escaned, Javier, Kakuta, Tsunekazu, Koo, Bon Kwon, Piek, Jan J., van de Hoef, Tim P., Cardiologie, Team Medisch, Circulatory Health, Boerhout, Coen K.M., Vink, C. E.M., Lee, Joo Myung, de Waard, Guus A., Mejia-Renteria, Hernan, Lee, Seung Hun, Jung, Ji Hyun, Hoshino, Masahiro, Echavarria-Pinto, Mauro, Meuwissen, Martijn, Matsuo, Hitoshi, Madera-Cambero, Maribel, Eftekhari, Ashkan, Effat, Mohamed A., Murai, Tadashi, Marques, Koen, Doh, Joon Hyung, Christiansen, Evald H., Banerjee, Rupak, Nam, Chang Wook, Niccoli, Giampaolo, Nakayama, Masafumi, Tanaka, Nobuhiro, Shin, Eun Seok, Appelman, Yolande, Beijk, Marcel A.M., van Royen, Niels, Chamuleau, Steven A.J., Knaapen, Paul, Escaned, Javier, Kakuta, Tsunekazu, Koo, Bon Kwon, Piek, Jan J., and van de Hoef, Tim P.
Published: 2024

2. Influence of Pathophysiological Patterns of Coronary Artery Disease on Immediate Percutaneous Coronary Intervention Outcomes

Author: Collet, Carlo, Munhoz, Daniel, Mizukami, Takuya, Sonck, Jeroen, Matsuo, Hitoshi, Shinke, Toshiro, Ando, Hirohiko, Ko, Brian, Biscaglia, Simone, Rivero, Fernando, Engstrøm, Thoma, Arslani, Ketina, Leone, Antonio Maria, van Nunen, Lokien X, Fearon, William F, Christiansen, Evald Høj, Fournier, Stephane, Desta, Liyew, Yong, Andy, Adjej, Julien, Escaned, Javier, Nakayama, Masafumi, Eftekhari, Ashkan, Zimmermann, Frederik M, Sakai, Koshiro, Storozhenko, Tatyana, da Costa, Bruno R, Campo, Gianluca, West, Nick E J, De Potter, Tom, Heggermont, Ward, Buytaert, Dimitri, Bartunek, Jozef, Berry, Colin, Collison, Damien, Johnson, Thoma, Amano, Tetsuya, Perera, Divaka, Jeremias, Allen, Ali, Ziad, Pijls, Nico H J, De Bruyne, Bernard, Johnson, Nils P, Leone, Antonio Maria (ORCID:0000-0002-1276-9883), Collet, Carlo, Munhoz, Daniel, Mizukami, Takuya, Sonck, Jeroen, Matsuo, Hitoshi, Shinke, Toshiro, Ando, Hirohiko, Ko, Brian, Biscaglia, Simone, Rivero, Fernando, Engstrøm, Thoma, Arslani, Ketina, Leone, Antonio Maria, van Nunen, Lokien X, Fearon, William F, Christiansen, Evald Høj, Fournier, Stephane, Desta, Liyew, Yong, Andy, Adjej, Julien, Escaned, Javier, Nakayama, Masafumi, Eftekhari, Ashkan, Zimmermann, Frederik M, Sakai, Koshiro, Storozhenko, Tatyana, da Costa, Bruno R, Campo, Gianluca, West, Nick E J, De Potter, Tom, Heggermont, Ward, Buytaert, Dimitri, Bartunek, Jozef, Berry, Colin, Collison, Damien, Johnson, Thoma, Amano, Tetsuya, Perera, Divaka, Jeremias, Allen, Ali, Ziad, Pijls, Nico H J, De Bruyne, Bernard, Johnson, Nils P, and Leone, Antonio Maria (ORCID:0000-0002-1276-9883)
Abstract: Background: Diffuse coronary artery disease (CAD) impacts the safety and efficacy of percutaneous coronary intervention (PCI). Pathophysiological CAD patterns can be quantified using fractional flow reserve (FFR) pullbacks incorporating the pullback pressure gradient (PPG) calculation. This study aimed to establish the capacity of PPG to predict optimal revascularisation and procedural outcomes. Methods: This prospective, investigator-initiated, single-arm, multicentre study enrolled patients with at least one epicardial lesion with an FFR ≤ 0.80 scheduled for PCI. Manual FFR pullbacks were employed to calculate PPG. The primary outcome of optimal revascularisation was defined as a post-PCI FFR ≥ 0.88. Results: 993 patients with 1044 vessels were included. The mean FFR was 0.68 ± 0.12, PPG 0.62 ± 0.17, and post-PCI FFR 0.87 ± 0.07. PPG was significantly correlated with the change in FFR after PCI (r=0.65, 95% CI 0.61-0.69, p<0.001) and demonstrated excellent predicted capacity for optimal revascularisation (AUC 0.82, 95% CI 0.79-0.84, p<0.001). Conversely, FFR alone did not predict revascularisation outcomes (AUC 0.54, 95% CI 0.50-0.57). PPG influenced treatment decisions in 14% of patients, redirecting them from PCI to alternative treatment modalities. Periprocedural myocardial infarction occurred more frequently in patients with low PPG (<0.62) compared to those with focal disease (OR 1.71, 95% CI: 1.00-2.97). Conclusions: Pathophysiological CAD patterns distinctly affect the safety and effectiveness of PCI. The PPG showed an excellent predictive capacity for optimal revascularisation and demonstrated added value compared to a FFR measurement.
Published: 2024

3. CMTM6 shapes antitumor T cell response through modulating protein expression of CD58 and PD-L1

Author: Miao, Beiping, Hu, Zhaoqing, Mezzadra, Riccardo, Hoeijmakers, Lotte, Fauster, Astrid, Du, Shangce, Yang, Zhi, Sator-Schmitt, Melanie, Engel, Helena, Li, Xueshen, Broderick, Caroline, Jin, Guangzhi, Gomez-Eerland, Raquel, Rozeman, Lisette, Lei, Xin, Matsuo, Hitoshi, Yang, Chen, Hofland, Ingrid, Peters, Dennis, Broeks, Annegien, Laport, Elke, Fitz, Annika, Zhao, Xiyue, Mahmoud, Mohamed A A, Ma, Xiujian, Sander, Sandrine, Liu, Hai-Kun, Cui, Guoliang, Gan, Yu, Wu, Wei, Xiao, Yanling, Heck, Albert J R, Guan, Wenxian, Lowe, Scott W, Horlings, Hugo M, Wang, Cun, Brummelkamp, Thijn R, Blank, Christian U, Schumacher, Ton N M, Sun, Chong, Miao, Beiping, Hu, Zhaoqing, Mezzadra, Riccardo, Hoeijmakers, Lotte, Fauster, Astrid, Du, Shangce, Yang, Zhi, Sator-Schmitt, Melanie, Engel, Helena, Li, Xueshen, Broderick, Caroline, Jin, Guangzhi, Gomez-Eerland, Raquel, Rozeman, Lisette, Lei, Xin, Matsuo, Hitoshi, Yang, Chen, Hofland, Ingrid, Peters, Dennis, Broeks, Annegien, Laport, Elke, Fitz, Annika, Zhao, Xiyue, Mahmoud, Mohamed A A, Ma, Xiujian, Sander, Sandrine, Liu, Hai-Kun, Cui, Guoliang, Gan, Yu, Wu, Wei, Xiao, Yanling, Heck, Albert J R, Guan, Wenxian, Lowe, Scott W, Horlings, Hugo M, Wang, Cun, Brummelkamp, Thijn R, Blank, Christian U, Schumacher, Ton N M, and Sun, Chong
Abstract: The dysregulated expression of immune checkpoint molecules enables cancer cells to evade immune destruction. While blockade of inhibitory immune checkpoints like PD-L1 forms the basis of current cancer immunotherapies, a deficiency in costimulatory signals can render these therapies futile. CD58, a costimulatory ligand, plays a crucial role in antitumor immune responses, but the mechanisms controlling its expression remain unclear. Using two systematic approaches, we reveal that CMTM6 positively regulates CD58 expression. Notably, CMTM6 interacts with both CD58 and PD-L1, maintaining the expression of these two immune checkpoint ligands with opposing functions. Functionally, the presence of CMTM6 and CD58 on tumor cells significantly affects T cell-tumor interactions and response to PD-L1-PD-1 blockade. Collectively, these findings provide fundamental insights into CD58 regulation, uncover a shared regulator of stimulatory and inhibitory immune checkpoints, and highlight the importance of tumor-intrinsic CMTM6 and CD58 expression in antitumor immune responses.
Published: 2023

4. CMTM6 shapes antitumor T cell response through modulating protein expression of CD58 and PD-L1

Author: Afd Biomol.Mass Spect. and Proteomics, Sub Biomol.Mass Spectrometry & Proteom., Biomolecular Mass Spectrometry and Proteomics, Miao, Beiping, Hu, Zhaoqing, Mezzadra, Riccardo, Hoeijmakers, Lotte, Fauster, Astrid, Du, Shangce, Yang, Zhi, Sator-Schmitt, Melanie, Engel, Helena, Li, Xueshen, Broderick, Caroline, Jin, Guangzhi, Gomez-Eerland, Raquel, Rozeman, Lisette, Lei, Xin, Matsuo, Hitoshi, Yang, Chen, Hofland, Ingrid, Peters, Dennis, Broeks, Annegien, Laport, Elke, Fitz, Annika, Zhao, Xiyue, Mahmoud, Mohamed A A, Ma, Xiujian, Sander, Sandrine, Liu, Hai-Kun, Cui, Guoliang, Gan, Yu, Wu, Wei, Xiao, Yanling, Heck, Albert J R, Guan, Wenxian, Lowe, Scott W, Horlings, Hugo M, Wang, Cun, Brummelkamp, Thijn R, Blank, Christian U, Schumacher, Ton N M, Sun, Chong, Afd Biomol.Mass Spect. and Proteomics, Sub Biomol.Mass Spectrometry & Proteom., Biomolecular Mass Spectrometry and Proteomics, Miao, Beiping, Hu, Zhaoqing, Mezzadra, Riccardo, Hoeijmakers, Lotte, Fauster, Astrid, Du, Shangce, Yang, Zhi, Sator-Schmitt, Melanie, Engel, Helena, Li, Xueshen, Broderick, Caroline, Jin, Guangzhi, Gomez-Eerland, Raquel, Rozeman, Lisette, Lei, Xin, Matsuo, Hitoshi, Yang, Chen, Hofland, Ingrid, Peters, Dennis, Broeks, Annegien, Laport, Elke, Fitz, Annika, Zhao, Xiyue, Mahmoud, Mohamed A A, Ma, Xiujian, Sander, Sandrine, Liu, Hai-Kun, Cui, Guoliang, Gan, Yu, Wu, Wei, Xiao, Yanling, Heck, Albert J R, Guan, Wenxian, Lowe, Scott W, Horlings, Hugo M, Wang, Cun, Brummelkamp, Thijn R, Blank, Christian U, Schumacher, Ton N M, and Sun, Chong
Published: 2023

5. Changes in microvascular resistance following percutaneous coronary intervention - From the ILIAS global registry

Author: Team Medisch, Eftekhari, Ashkan, van de Hoef, Tim P, Hoshino, Masahiro, Lee, Joo Myung, Boerhout, Coen K M, de Waard, Guus A, Jung, Ji-Hyun, Lee, Seung Hun, Mejia-Renteria, Hernan, Echavarria-Pinto, Mauro, Meuwissen, Martijn, Matsuo, Hitoshi, Madera-Cambero, Maribel, Effat, Mohamed A, Marques, Koen, Doh, Joon-Hyung, Banerjee, Rupak, Nam, Chang-Wook, Niccoli, Giampaolo, Murai, Tadashi, Nakayama, Masafumi, Tanaka, Nobuhiro, Shin, Eun-Seok, Knaapen, Paul, van Royen, Niels, Escaned, Javier, Koo, Bon Kwon, Chamuleau, Steven A J, Kakuta, Tsunekazu, Piek, Jan J, Christiansen, Evald Høj, Team Medisch, Eftekhari, Ashkan, van de Hoef, Tim P, Hoshino, Masahiro, Lee, Joo Myung, Boerhout, Coen K M, de Waard, Guus A, Jung, Ji-Hyun, Lee, Seung Hun, Mejia-Renteria, Hernan, Echavarria-Pinto, Mauro, Meuwissen, Martijn, Matsuo, Hitoshi, Madera-Cambero, Maribel, Effat, Mohamed A, Marques, Koen, Doh, Joon-Hyung, Banerjee, Rupak, Nam, Chang-Wook, Niccoli, Giampaolo, Murai, Tadashi, Nakayama, Masafumi, Tanaka, Nobuhiro, Shin, Eun-Seok, Knaapen, Paul, van Royen, Niels, Escaned, Javier, Koo, Bon Kwon, Chamuleau, Steven A J, Kakuta, Tsunekazu, Piek, Jan J, and Christiansen, Evald Høj
Published: 2023

6. Microvascular resistance reserve: diagnostic and prognostic performance in the ILIAS registry

Author: Team Medisch, Boerhout, Coen K M, Lee, Joo Myung, de Waard, Guus A, Mejia-Renteria, Hernan, Lee, Seung Hun, Jung, Ji-Hyun, Hoshino, Masahiro, Echavarria-Pinto, Mauro, Meuwissen, Martijn, Matsuo, Hitoshi, Madera-Cambero, Maribel, Eftekhari, Ashkan, Effat, Mohamed A, Murai, Tadashi, Marques, Koen, Doh, Joon-Hyung, Christiansen, Evald H, Banerjee, Rupak, Nam, Chang-Wook, Niccoli, Giampaolo, Nakayama, Masafumi, Tanaka, Nobuhiro, Shin, Eun-Seok, Appelman, Yolande, Beijk, Marcel A M, van Royen, Niels, Knaapen, Paul, Escaned, Javier, Kakuta, Tsunekazu, Koo, Bon Kwon, Piek, Jan J, van de Hoef, Tim P, Team Medisch, Boerhout, Coen K M, Lee, Joo Myung, de Waard, Guus A, Mejia-Renteria, Hernan, Lee, Seung Hun, Jung, Ji-Hyun, Hoshino, Masahiro, Echavarria-Pinto, Mauro, Meuwissen, Martijn, Matsuo, Hitoshi, Madera-Cambero, Maribel, Eftekhari, Ashkan, Effat, Mohamed A, Murai, Tadashi, Marques, Koen, Doh, Joon-Hyung, Christiansen, Evald H, Banerjee, Rupak, Nam, Chang-Wook, Niccoli, Giampaolo, Nakayama, Masafumi, Tanaka, Nobuhiro, Shin, Eun-Seok, Appelman, Yolande, Beijk, Marcel A M, van Royen, Niels, Knaapen, Paul, Escaned, Javier, Kakuta, Tsunekazu, Koo, Bon Kwon, Piek, Jan J, and van de Hoef, Tim P
Published: 2023

7. Impact of core laboratory assessment on treatment decisions and clinical outcomes using combined fractional flow reserve and coronary flow reserve measurements - DEFINE-FLOW core laboratory sub-study

Author: Team Medisch, van de Hoef, Tim P, Stegehuis, Valérie E, Madera-Cambero, Maribel I, van Royen, Niels, van der Hoeven, Nina W, de Waard, Guus A, Meuwissen, Martijn, Christiansen, Evald H, Eftekhari, Ashkan, Niccoli, Giampaolo, Lockie, Tim, Matsuo, Hitoshi, Nakayama, Masafumi, Kakuta, Tsunekazu, Tanaka, Nobuhiro, Casadonte, Lorena, Spaan, Jos A E, Siebes, Maria, Tijssen, Jan G P, Escaned, Javier, Piek, Jan J, Team Medisch, van de Hoef, Tim P, Stegehuis, Valérie E, Madera-Cambero, Maribel I, van Royen, Niels, van der Hoeven, Nina W, de Waard, Guus A, Meuwissen, Martijn, Christiansen, Evald H, Eftekhari, Ashkan, Niccoli, Giampaolo, Lockie, Tim, Matsuo, Hitoshi, Nakayama, Masafumi, Kakuta, Tsunekazu, Tanaka, Nobuhiro, Casadonte, Lorena, Spaan, Jos A E, Siebes, Maria, Tijssen, Jan G P, Escaned, Javier, and Piek, Jan J
Published: 2023

8. Sex differences in prevalence and outcomes of the different endotypes of chronic coronary syndrome in symptomatic patients undergoing invasive coronary angiography: Insights from the global ILIAS invasive coronary physiology registry

Author: Team Medisch, Vink, Caitlin E M, Woudstra, Janneke, Lee, Joo Myung, Boerhout, Coen K M, Cook, Christopher M, Hoshino, Masahiro, Mejia-Renteria, Hernan, Lee, Seung Hun, Jung, Ji-Hyun, Echavarria-Pinto, Mauro, Meuwissen, Martijn, Matsuo, Hitoshi, Madera-Cambero, Maribel, Eftekhari, Ashkan, Effat, Mohamed A, Murai, Tadashi, Marques, Koen, Beijk, Marcel A M, Doh, Joon-Hyung, Piek, Jan J, van de Hoef, Tim P, Christiansen, Evald Høj, Banerjee, Rupak, Nam, Chang-Wook, Niccoli, Giampaolo, Nakayama, Masafumi, Tanaka, Nobuhiro, Shin, Eun-Seok, van Royen, Niels, Chamuleau, Steven A J, Knaapen, Paul, Escaned, Javier, Kakuta, Tsunekazu, Koo, Bon-Kwon, Appelman, Yolande, de Waard, Guus A, Team Medisch, Vink, Caitlin E M, Woudstra, Janneke, Lee, Joo Myung, Boerhout, Coen K M, Cook, Christopher M, Hoshino, Masahiro, Mejia-Renteria, Hernan, Lee, Seung Hun, Jung, Ji-Hyun, Echavarria-Pinto, Mauro, Meuwissen, Martijn, Matsuo, Hitoshi, Madera-Cambero, Maribel, Eftekhari, Ashkan, Effat, Mohamed A, Murai, Tadashi, Marques, Koen, Beijk, Marcel A M, Doh, Joon-Hyung, Piek, Jan J, van de Hoef, Tim P, Christiansen, Evald Høj, Banerjee, Rupak, Nam, Chang-Wook, Niccoli, Giampaolo, Nakayama, Masafumi, Tanaka, Nobuhiro, Shin, Eun-Seok, van Royen, Niels, Chamuleau, Steven A J, Knaapen, Paul, Escaned, Javier, Kakuta, Tsunekazu, Koo, Bon-Kwon, Appelman, Yolande, and de Waard, Guus A
Published: 2023

9. Prognostic value of coronary computed tomography angiographic derived fractional flow reserve:a systematic review and meta-analysis

Author: Nørgaard, Bjarne L., Gaur, Sara, Fairbairn, Timothy A., Douglas, Pam S., Jensen, Jesper M., Patel, Manesh R., Ihdayhid, Abdul R., Ko, Brian S.H., Sellers, Stephanie L., Weir-McCall, Jonathan, Matsuo, Hitoshi, Sand, Niels Peter R., Øvrehus, Kristian A., Rogers, Campbell, Mullen, Sarah, Nieman, Koen, Parner, Erik, Leipsic, Jonathon, Abdulla, Jawdat, Nørgaard, Bjarne L., Gaur, Sara, Fairbairn, Timothy A., Douglas, Pam S., Jensen, Jesper M., Patel, Manesh R., Ihdayhid, Abdul R., Ko, Brian S.H., Sellers, Stephanie L., Weir-McCall, Jonathan, Matsuo, Hitoshi, Sand, Niels Peter R., Øvrehus, Kristian A., Rogers, Campbell, Mullen, Sarah, Nieman, Koen, Parner, Erik, Leipsic, Jonathon, and Abdulla, Jawdat
Abstract: OBJECTIVES: To obtain more powerful assessment of the prognostic value of fractional flow reserveCT testing we performed a systematic literature review and collaborative meta-analysis of studies that assessed clinical outcomes of CT-derived calculation of FFR (FFRCT) (HeartFlow) analysis in patients with stable coronary artery disease (CAD). METHODS: We searched PubMed and Web of Science electronic databases for published studies that evaluated clinical outcomes following fractional flow reserveCT testing between 1 January 2010 and 31 December 2020. The primary endpoint was defined as 'all-cause mortality (ACM) or myocardial infarction (MI)' at 12-month follow-up. Exploratory analyses were performed using major adverse cardiovascular events (MACEs, ACM+MI+unplanned revascularisation), ACM, MI, spontaneous MI or unplanned (>3 months) revascularisation as the endpoint. RESULTS: Five studies were identified including a total of 5460 patients eligible for meta-analyses. The primary endpoint occurred in 60 (1.1%) patients, 0.6% (13/2126) with FFRCT>0.80% and 1.4% (47/3334) with FFRCT ≤0.80 (relative risk (RR) 2.31 (95% CI 1.29 to 4.13), p=0.005). Likewise, MACE, MI, spontaneous MI or unplanned revascularisation occurred more frequently in patients with FFRCT ≤0.80 versus patients with FFRCT >0.80. Each 0.10-unit FFRCT reduction was associated with a greater risk of the primary endpoint (RR 1.67 (95% CI 1.47 to 1.87), p<0.001). CONCLUSIONS: The 12-month outcomes in patients with stable CAD show low rates of events in those with a negative FFRCT result, and lower risk of an unfavourable outcome in patients with a negative test result compared with patients with a positive test result. Moreover, the FFRCT numerical value was inversely associated with outcomes.
Published: 2022

10. Prognostic value of coronary computed tomography angiographic derived fractional flow reserve:a systematic review and meta-analysis

Author: Nørgaard, Bjarne L., Gaur, Sara, Fairbairn, Timothy A., Douglas, Pam S., Jensen, Jesper M., Patel, Manesh R., Ihdayhid, Abdul R., Ko, Brian S.H., Sellers, Stephanie L., Weir-McCall, Jonathan, Matsuo, Hitoshi, Sand, Niels Peter R., Øvrehus, Kristian A., Rogers, Campbell, Mullen, Sarah, Nieman, Koen, Parner, Erik, Leipsic, Jonathon, Abdulla, Jawdat, Nørgaard, Bjarne L., Gaur, Sara, Fairbairn, Timothy A., Douglas, Pam S., Jensen, Jesper M., Patel, Manesh R., Ihdayhid, Abdul R., Ko, Brian S.H., Sellers, Stephanie L., Weir-McCall, Jonathan, Matsuo, Hitoshi, Sand, Niels Peter R., Øvrehus, Kristian A., Rogers, Campbell, Mullen, Sarah, Nieman, Koen, Parner, Erik, Leipsic, Jonathon, and Abdulla, Jawdat
Abstract: OBJECTIVES: To obtain more powerful assessment of the prognostic value of fractional flow reserveCT testing we performed a systematic literature review and collaborative meta-analysis of studies that assessed clinical outcomes of CT-derived calculation of FFR (FFRCT) (HeartFlow) analysis in patients with stable coronary artery disease (CAD). METHODS: We searched PubMed and Web of Science electronic databases for published studies that evaluated clinical outcomes following fractional flow reserveCT testing between 1 January 2010 and 31 December 2020. The primary endpoint was defined as 'all-cause mortality (ACM) or myocardial infarction (MI)' at 12-month follow-up. Exploratory analyses were performed using major adverse cardiovascular events (MACEs, ACM+MI+unplanned revascularisation), ACM, MI, spontaneous MI or unplanned (>3 months) revascularisation as the endpoint. RESULTS: Five studies were identified including a total of 5460 patients eligible for meta-analyses. The primary endpoint occurred in 60 (1.1%) patients, 0.6% (13/2126) with FFRCT>0.80% and 1.4% (47/3334) with FFRCT ≤0.80 (relative risk (RR) 2.31 (95% CI 1.29 to 4.13), p=0.005). Likewise, MACE, MI, spontaneous MI or unplanned revascularisation occurred more frequently in patients with FFRCT ≤0.80 versus patients with FFRCT >0.80. Each 0.10-unit FFRCT reduction was associated with a greater risk of the primary endpoint (RR 1.67 (95% CI 1.47 to 1.87), p<0.001). CONCLUSIONS: The 12-month outcomes in patients with stable CAD show low rates of events in those with a negative FFRCT result, and lower risk of an unfavourable outcome in patients with a negative test result compared with patients with a positive test result. Moreover, the FFRCT numerical value was inversely associated with outcomes.
Published: 2022

11. SoftNeuro: Fast Deep Inference using Multi-platform Optimization

Author: Hilaga, Masaki, Kuroda, Yasuhiro, Matsuo, Hitoshi, Kawaguchi, Tatsuya, Ogawa, Gabriel, Miyake, Hiroshi, Kozawa, Yusuke, Hilaga, Masaki, Kuroda, Yasuhiro, Matsuo, Hitoshi, Kawaguchi, Tatsuya, Ogawa, Gabriel, Miyake, Hiroshi, and Kozawa, Yusuke
Abstract: Faster inference of deep learning models is highly demanded on edge devices and even servers, for both financial and environmental reasons. To address this issue, we propose SoftNeuro, a novel, high-performance inference framework with efficient performance tuning. The key idea is to separate algorithmic routines from network layers. Our framework maximizes the inference performance by profiling various routines for each layer and selecting the fastest path. To efficiently find the best path, we propose a routine-selection algorithm based on dynamic programming. Experiments show that the proposed framework achieves both fast inference and efficient tuning., Comment: 8 pages, 3 figures
Published: 2021

12. Diagnostic Performance of Angiogram-Derived Fractional Flow Reserve:A Pooled Analysis of 5 Prospective Cohort Studies

Author: Witberg, Guy, De Bruyne, Bernard, Fearon, William F., Achenbach, Stephan, Engstrom, Thomas, Matsuo, Hitoshi, Kornowski, Ran, Witberg, Guy, De Bruyne, Bernard, Fearon, William F., Achenbach, Stephan, Engstrom, Thomas, Matsuo, Hitoshi, and Kornowski, Ran
Abstract: Objectives: This study sought to assess the diagnostic performance of FFRangio (CathWorks, Kfar Saba, Israel), an angiogram-derived fractional flow reserve (FFR) technology. Background: Despite practice guidelines recommendations, the use of coronary physiologic assessment in daily practice remains low for patients undergoing coronary angiography. Angiogram-derived FFR technologies have the potential to promote the integration of physiologic assessment in daily practice. Methods: The study performed an analysis of pooled patient- and lesion-level data from 5 prospective cohort studies that examined the diagnostic performance of FFRangio compared with the reference standard wire-based FFR. Results: A total of 700 lesions from 588 patients were analyzed. Mean age was 65 years, 71% were men, and 40% presented with acute coronary syndromes. Mean FFR and FFRangio were 0.81 ± 0.12 and 0.81 ± 0.11, with 31.6% and 31.4% of lesions were in the 0.75 to 0.85 range, respectively. When using a binary cutoff FFR value of 0.80, FFRangio showed a sensitivity of 91%, a specificity of 94%, and a diagnostic accuracy of 93%. The mean difference between FFR and FFRangio was 0.00 ± 0.12. The correlation coefficient between FFR and FFRangio was 0.83 (p < 0.001). The C-statistic for FFRangio was 0.95 (p < 0.001). The accuracy of FFRangio was consistent across all subgroups examined. Conclusions: In the largest reported cohort examining the performance of angiogram-derived FFR technology, FFRangio showed excellent diagnostic performance, which was robust and consistent across all patient and lesion subgroups. Additional studies are needed allow FFRangio and fulfill its potential expand the implementation of functional assessment of coronary lesions in routine clinical practice.
Published: 2020

13. Clinical Events After Deferral of LAD Revascularization Following Physiological Coronary Assessment.

Author: Sen, Sayan, Sen, Sayan, Ahmad, Yousif, Dehbi, Hakim-Moulay, Howard, James P, Iglesias, Juan F, Al-Lamee, Rasha, Petraco, Ricardo, Nijjer, Sukhjinder, Bhindi, Ravinay, Lehman, Sam, Walters, Darren, Sapontis, James, Janssens, Luc, Vrints, Christiaan J, Khashaba, Ahmed, Laine, Mika, Van Belle, Eric, Krackhardt, Florian, Bojara, Waldemar, Going, Olaf, Härle, Tobias, Indolfi, Ciro, Niccoli, Giampaolo, Ribichini, Flavio, Tanaka, Nobuhiro, Yokoi, Hiroyoshi, Takashima, Hiroaki, Kikuta, Yuetsu, Erglis, Andrejs, Vinhas, Hugo, Silva, Pedro Canas, Baptista, Sérgio B, Alghamdi, Ali, Hellig, Farrel, Koo, Bon-Kwon, Nam, Chang-Wook, Shin, Eun-Seok, Doh, Joon-Hyung, Brugaletta, Salvatore, Alegria-Barrero, Eduardo, Meuwissen, Martijin, Piek, Jan J, van Royen, Niels, Sezer, Murat, Di Mario, Carlo, Gerber, Robert T, Malik, Iqbal S, Sharp, Andrew SP, Talwar, Suneel, Tang, Kare, Samady, Habib, Altman, John, Seto, Arnold H, Singh, Jasvindar, Jeremias, Allen, Matsuo, Hitoshi, Kharbanda, Rajesh K, Patel, Manesh R, Serruys, Patrick, Escaned, Javier, Davies, Justin E, Sen, Sayan, Sen, Sayan, Ahmad, Yousif, Dehbi, Hakim-Moulay, Howard, James P, Iglesias, Juan F, Al-Lamee, Rasha, Petraco, Ricardo, Nijjer, Sukhjinder, Bhindi, Ravinay, Lehman, Sam, Walters, Darren, Sapontis, James, Janssens, Luc, Vrints, Christiaan J, Khashaba, Ahmed, Laine, Mika, Van Belle, Eric, Krackhardt, Florian, Bojara, Waldemar, Going, Olaf, Härle, Tobias, Indolfi, Ciro, Niccoli, Giampaolo, Ribichini, Flavio, Tanaka, Nobuhiro, Yokoi, Hiroyoshi, Takashima, Hiroaki, Kikuta, Yuetsu, Erglis, Andrejs, Vinhas, Hugo, Silva, Pedro Canas, Baptista, Sérgio B, Alghamdi, Ali, Hellig, Farrel, Koo, Bon-Kwon, Nam, Chang-Wook, Shin, Eun-Seok, Doh, Joon-Hyung, Brugaletta, Salvatore, Alegria-Barrero, Eduardo, Meuwissen, Martijin, Piek, Jan J, van Royen, Niels, Sezer, Murat, Di Mario, Carlo, Gerber, Robert T, Malik, Iqbal S, Sharp, Andrew SP, Talwar, Suneel, Tang, Kare, Samady, Habib, Altman, John, Seto, Arnold H, Singh, Jasvindar, Jeremias, Allen, Matsuo, Hitoshi, Kharbanda, Rajesh K, Patel, Manesh R, Serruys, Patrick, Escaned, Javier, and Davies, Justin E
Abstract: BackgroundPhysicians are not always comfortable deferring treatment of a stenosis in the left anterior descending (LAD) artery because of the perception that there is a high risk of major adverse cardiac events (MACE). The authors describe, using the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) trial, MACE rates when LAD lesions are deferred, guided by physiological assessment using fractional flow reserve (FFR) or the instantaneous wave-free ratio (iFR).ObjectivesThe purpose of this study was to establish the safety of deferring treatment in the LAD using FFR or iFR within the DEFINE-FLAIR trial.MethodsMACE rates at 1 year were compared between groups (iFR and FFR) in patients whose physiological assessment led to LAD lesions being deferred. MACE was defined as a composite of cardiovascular death, myocardial infarction (MI), and unplanned revascularization at 1 year. Patients, and staff performing follow-up, were blinded to whether the decision was made with FFR or iFR. Outcomes were adjusted for age and sex.ResultsA total of 872 patients had lesions deferred in the LAD (421 guided by FFR, 451 guided by iFR). The event rate with iFR was significantly lower than with FFR (2.44% vs. 5.26%; adjusted HR: 0.46; 95% confidence interval [CI]: 0.22 to 0.95; p = 0.04). This was driven by significantly lower unplanned revascularization with iFR and numerically lower MI (unplanned revascularization: 2.22% iFR vs. 4.99% FFR; adjusted HR: 0.44; 95% CI: 0.21 to 0.93; p = 0.03; MI: 0.44% iFR vs. 2.14% FFR; adjusted HR: 0.23; 95% CI: 0.05 to 1.07; p = 0.06).ConclusionsiFR-guided deferral appears to be safe for patients with LAD lesions. Patients in whom iFR-guided deferral was performed had statistically significantly lower event rates than those with FFR-guided deferral.
Published: 2019

14. Clinical Events After Deferral of LAD Revascularization Following Physiological Coronary Assessment.

Author: Sen, Sayan, Sen, Sayan, Ahmad, Yousif, Dehbi, Hakim-Moulay, Howard, James P, Iglesias, Juan F, Al-Lamee, Rasha, Petraco, Ricardo, Nijjer, Sukhjinder, Bhindi, Ravinay, Lehman, Sam, Walters, Darren, Sapontis, James, Janssens, Luc, Vrints, Christiaan J, Khashaba, Ahmed, Laine, Mika, Van Belle, Eric, Krackhardt, Florian, Bojara, Waldemar, Going, Olaf, Härle, Tobias, Indolfi, Ciro, Niccoli, Giampaolo, Ribichini, Flavio, Tanaka, Nobuhiro, Yokoi, Hiroyoshi, Takashima, Hiroaki, Kikuta, Yuetsu, Erglis, Andrejs, Vinhas, Hugo, Silva, Pedro Canas, Baptista, Sérgio B, Alghamdi, Ali, Hellig, Farrel, Koo, Bon-Kwon, Nam, Chang-Wook, Shin, Eun-Seok, Doh, Joon-Hyung, Brugaletta, Salvatore, Alegria-Barrero, Eduardo, Meuwissen, Martijin, Piek, Jan J, van Royen, Niels, Sezer, Murat, Di Mario, Carlo, Gerber, Robert T, Malik, Iqbal S, Sharp, Andrew SP, Talwar, Suneel, Tang, Kare, Samady, Habib, Altman, John, Seto, Arnold H, Singh, Jasvindar, Jeremias, Allen, Matsuo, Hitoshi, Kharbanda, Rajesh K, Patel, Manesh R, Serruys, Patrick, Escaned, Javier, Davies, Justin E, Sen, Sayan, Sen, Sayan, Ahmad, Yousif, Dehbi, Hakim-Moulay, Howard, James P, Iglesias, Juan F, Al-Lamee, Rasha, Petraco, Ricardo, Nijjer, Sukhjinder, Bhindi, Ravinay, Lehman, Sam, Walters, Darren, Sapontis, James, Janssens, Luc, Vrints, Christiaan J, Khashaba, Ahmed, Laine, Mika, Van Belle, Eric, Krackhardt, Florian, Bojara, Waldemar, Going, Olaf, Härle, Tobias, Indolfi, Ciro, Niccoli, Giampaolo, Ribichini, Flavio, Tanaka, Nobuhiro, Yokoi, Hiroyoshi, Takashima, Hiroaki, Kikuta, Yuetsu, Erglis, Andrejs, Vinhas, Hugo, Silva, Pedro Canas, Baptista, Sérgio B, Alghamdi, Ali, Hellig, Farrel, Koo, Bon-Kwon, Nam, Chang-Wook, Shin, Eun-Seok, Doh, Joon-Hyung, Brugaletta, Salvatore, Alegria-Barrero, Eduardo, Meuwissen, Martijin, Piek, Jan J, van Royen, Niels, Sezer, Murat, Di Mario, Carlo, Gerber, Robert T, Malik, Iqbal S, Sharp, Andrew SP, Talwar, Suneel, Tang, Kare, Samady, Habib, Altman, John, Seto, Arnold H, Singh, Jasvindar, Jeremias, Allen, Matsuo, Hitoshi, Kharbanda, Rajesh K, Patel, Manesh R, Serruys, Patrick, Escaned, Javier, and Davies, Justin E
Abstract: BackgroundPhysicians are not always comfortable deferring treatment of a stenosis in the left anterior descending (LAD) artery because of the perception that there is a high risk of major adverse cardiac events (MACE). The authors describe, using the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) trial, MACE rates when LAD lesions are deferred, guided by physiological assessment using fractional flow reserve (FFR) or the instantaneous wave-free ratio (iFR).ObjectivesThe purpose of this study was to establish the safety of deferring treatment in the LAD using FFR or iFR within the DEFINE-FLAIR trial.MethodsMACE rates at 1 year were compared between groups (iFR and FFR) in patients whose physiological assessment led to LAD lesions being deferred. MACE was defined as a composite of cardiovascular death, myocardial infarction (MI), and unplanned revascularization at 1 year. Patients, and staff performing follow-up, were blinded to whether the decision was made with FFR or iFR. Outcomes were adjusted for age and sex.ResultsA total of 872 patients had lesions deferred in the LAD (421 guided by FFR, 451 guided by iFR). The event rate with iFR was significantly lower than with FFR (2.44% vs. 5.26%; adjusted HR: 0.46; 95% confidence interval [CI]: 0.22 to 0.95; p = 0.04). This was driven by significantly lower unplanned revascularization with iFR and numerically lower MI (unplanned revascularization: 2.22% iFR vs. 4.99% FFR; adjusted HR: 0.44; 95% CI: 0.21 to 0.93; p = 0.03; MI: 0.44% iFR vs. 2.14% FFR; adjusted HR: 0.23; 95% CI: 0.05 to 1.07; p = 0.06).ConclusionsiFR-guided deferral appears to be safe for patients with LAD lesions. Patients in whom iFR-guided deferral was performed had statistically significantly lower event rates than those with FFR-guided deferral.
Published: 2019

15. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
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16. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
Full Text: View/download PDF

17. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
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18. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
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19. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
Full Text: View/download PDF

20. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
Full Text: View/download PDF

21. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p amp;lt; 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used, Funding Agencies|Philips; Upsala Clinical Research Centre; Volcano; Imperial College; Philips Volcano; Imperial College London; Medical Research Council
Published: 2018
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22. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
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23. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p amp;lt; 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used, Funding Agencies|Philips; Upsala Clinical Research Centre; Volcano; Imperial College; Philips Volcano; Imperial College London; Medical Research Council
Published: 2018
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24. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
Full Text: View/download PDF

25. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p amp;lt; 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used, Funding Agencies|Philips; Upsala Clinical Research Centre; Volcano; Imperial College; Philips Volcano; Imperial College London; Medical Research Council
Published: 2018
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26. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
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27. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p amp;lt; 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used, Funding Agencies|Philips; Upsala Clinical Research Centre; Volcano; Imperial College; Philips Volcano; Imperial College London; Medical Research Council
Published: 2018
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28. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jörg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to
Published: 2018
Full Text: View/download PDF

29. 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

Author: Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., Gotberg, Matthias, Escaned, Javier, Ryan, Nicola, Mejia-Renteria, Hernan, Cook, Christopher M., Dehbi, Hakim-Moulay, Alegria-Barrero, Eduardo, Alghamdi, Ali, Al-Lamee, Rasha, Altman, John, Ambrosia, Alphonse, Baptista, Sergio B., Bertilsson, Maria, Bhindi, Ravinay, Birgander, Mats, Bojara, Waldemar, Brugaletta, Salvatore, Buller, Christopher, Calais, Fredrik, Silva, Pedro Canas, Carlsson, Jorg, Christiansen, Evald H., Danielewicz, Mikael, Di Mario, Carlo, Doh, Joon-Hyung, Erglis, Andrejs, Erlinge, David, Gerber, Robert T., Going, Olaf, Gudmundsdottir, Ingibjorg, Haerle, Tobias, Hauer, Dario, Hellig, Farrel, Indolfi, Ciro, Jakobsen, Lars, Janssens, Luc, Jensen, Jens, Jeremias, Allen, Karegren, Amra, Karlsson, Ann-Charlotte, Kharbanda, Rajesh K., Khashaba, Ahmed, Kikuta, Yuetsu, Krackhardt, Florian, Koo, Bon-Kwon, Koul, Sasha, Laine, Mika, Lehman, Sam J., Lindroos, Pontus, Malik, Iqbal S., Maeng, Michael, Matsuo, Hitoshi, Meuwissen, Martijn, Nam, Chang-Wook, Niccoli, Giampaolo, Nijjer, Sukhjinder S., Olsson, Hans, Olsson, Sven-Erik, Omerovic, Elmir, Panayi, Georgios, Petraco, Ricardo, Piek, Jan J., Ribichini, Flavo, Samady, Habib, Samuels, Bruce, Sandhall, Lennart, Sapontis, James, Sen, Sayan, Seto, Arnold H., Sezer, Murat, Sharp, Andrew S. P., Shin, Eun-Seok, Singh, Jasvindar, Takashima, Hiroaki, Talwar, Suneel, Tanaka, Nobuhiro, Tang, Kare, Van Belle, Eric, van Royen, Niels, Varenhorst, Christoph, Vinhas, Hugo, Vrints, Christiaan J., Walters, Darren, Yokoi, Hiroyoshi, Frobert, Ole, Patel, Manesh R., Serruys, Patrick, Davies, Justin E., and Gotberg, Matthias
Abstract: OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p amp;lt; 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used, Funding Agencies|Philips; Upsala Clinical Research Centre; Volcano; Imperial College; Philips Volcano; Imperial College London; Medical Research Council
Published: 2018
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30. Horizontally oriented molecular thin films for application in organic solar cells

Author: Matsushima, Toshinori, Matsuo, Hitoshi, Yamamoto, Tetsuo, Nakao, Akichika, Murata, Hideyuki, Matsushima, Toshinori, Matsuo, Hitoshi, Yamamoto, Tetsuo, Nakao, Akichika, and Murata, Hideyuki
Abstract: The authors investigate the influence of molecular orientation of p-type molecules of alpha-sexithiophene (α-6T) and n-type molecules of 3,4,9,10-perylene tetracarboxylic bisbenzimidazole (PTCBI) on organic solar cell (OSC) performance. Deposition of α-6T and subsequently PTCBI on an α-6T buffer surface rubbed with a nylon cloth allows their horizontal orientations to be formed in separate layers. Power conversion efficiency and operation stability of a rubbed OSC are markedly improved when compared with an unrubbed OSC. The improved OSC performance is confirmed to be due to increases in light absorption, exciton diffusion length, energy difference between the p-type and n-type layers, and carrier collection by electrodes, which are caused by the rubbing-induced double horizontal orientations.
Published: 2014

31. Effects of Jejunoileal Transplantation on Myoelectrical Activity in the Rat Small Intestine

Author: Okamoto, Haruhiko, Sakai, Yasuo, Sato, Kenji, Matsuo, Hitoshi, Hatakeyama, Katsuyoshi, Muto, Terukazu, Okamoto, Haruhiko, Sakai, Yasuo, Sato, Kenji, Matsuo, Hitoshi, Hatakeyama, Katsuyoshi, and Muto, Terukazu
Abstract: Background: Clinically, many attempts at small intestinal transplantation in humans have been performed. Although little is known about the long term results on motor function of the transplanted small intestine, small intestinal motility should continue to be one of the most important issues in small intestinal transplantation. Study design: We investigated small intestinal motility 10 to 15 months after orthotopic small intestinal transplantation in rats. Six male Lewis rats underwent orthotopic jejunoileal transplantation. Intestinal myoelectric activity was recorded in the rats using Ag-AgCl bipolar electrodes. Six age-matched Lewis rats were also studied as controls. Results: The cycle length of migrating myoelectric complexes (MMCs) in the transplanted jejunum (T-J), recipient's jejunum (R-J), and jejunum of the control rat (C-J) groups were 16.2±3.8 min, 13.7±1.4 min, and 1l.1±0.3 min, respectively. In the C-J and T-J, a respective 98.1% and 96.5% of phase IIIs at the distal site occurred following the phase IIIs at the proximal site within 20% variation of the MMC period. However, between the R-J and T-J, only 31.0% of phase IIIs occurred within 20% variation of the MMC period. Coordination of the MMCs between the recipient and transplanted intestine did not occur at 10 to 15 months after the operation in the rat. During fasting, MMCs were clearly identified in the small intestine of both control and transplanted rats. Feeding interrupted the periodic activity, and irregular spike activity was observed along the entire small intestine, though conversion of the fasting to the fed pattern was delayed by about a minute in the graft intestine. The slow wave frequencies in the T-J, R-J, and C-J were 32.8±2.7 cpm, 36.3 ± 2.7 cpm and 36.3 ± 2.4 cpm, respectively. Conclusion: These results suggest that the motility of the transplanted small intestine is mostly preserved, however, temporal coordination of the MMCs across the anastomosis did not occur after transplant
Published: 1997

32. Effects of Jejunoileal Transplantation on Myoelectrical Activity in the Rat Small Intestine

Author: Okamoto, Haruhiko, 52668, Sakai, Yasuo, 52669, Sato, Kenji, 52670, Matsuo, Hitoshi, 52671, Hatakeyama, Katsuyoshi, 52672, Muto, Terukazu, 52673, Okamoto, Haruhiko, 52668, Sakai, Yasuo, 52669, Sato, Kenji, 52670, Matsuo, Hitoshi, 52671, Hatakeyama, Katsuyoshi, 52672, Muto, Terukazu, and 52673
Abstract: Background: Clinically, many attempts at small intestinal transplantation in humans have been performed. Although little is known about the long term results on motor function of the transplanted small intestine, small intestinal motility should continue to be one of the most important issues in small intestinal transplantation. Study design: We investigated small intestinal motility 10 to 15 months after orthotopic small intestinal transplantation in rats. Six male Lewis rats underwent orthotopic jejunoileal transplantation. Intestinal myoelectric activity was recorded in the rats using Ag-AgCl bipolar electrodes. Six age-matched Lewis rats were also studied as controls. Results: The cycle length of migrating myoelectric complexes (MMCs) in the transplanted jejunum (T-J), recipient's jejunum (R-J), and jejunum of the control rat (C-J) groups were 16.2±3.8 min, 13.7±1.4 min, and 1l.1±0.3 min, respectively. In the C-J and T-J, a respective 98.1% and 96.5% of phase IIIs at the distal site occurred following the phase IIIs at the proximal site within 20% variation of the MMC period. However, between the R-J and T-J, only 31.0% of phase IIIs occurred within 20% variation of the MMC period. Coordination of the MMCs between the recipient and transplanted intestine did not occur at 10 to 15 months after the operation in the rat. During fasting, MMCs were clearly identified in the small intestine of both control and transplanted rats. Feeding interrupted the periodic activity, and irregular spike activity was observed along the entire small intestine, though conversion of the fasting to the fed pattern was delayed by about a minute in the graft intestine. The slow wave frequencies in the T-J, R-J, and C-J were 32.8±2.7 cpm, 36.3 ± 2.7 cpm and 36.3 ± 2.4 cpm, respectively. Conclusion: These results suggest that the motility of the transplanted small intestine is mostly preserved, however, temporal coordination of the MMCs across the anastomosis did not occur after transplant, departmental bulletin paper
Published: 1997

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32 results on '"Matsuo, Hitoshi"'

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23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

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31. Effects of Jejunoileal Transplantation on Myoelectrical Activity in the Rat Small Intestine

32. Effects of Jejunoileal Transplantation on Myoelectrical Activity in the Rat Small Intestine

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