PhD Scientific Days 2021

CL_I_L: Clinical Medicine I. Lectures

The Correlation and Relative Prognostic Value of FFR and Pd/Pa of Non-Culprit Lesions in STEMI

Előadó neve

Dr. Piróth, Zsolt

Előadó munkahelye

GOKVI

Előadó telefonszáma

06-70-3820-437

Előadó e-mail címe

zpiroth@gmail.com

Az előadás címe

The Correlation and Relative Prognostic Value of FFR and Pd/Pa of Non-Culprit Lesions in STEMI

Szerző(k) neve és munkahelye

Zsolt Piróth MD PhD1, Gábor Fülöp MD1, Bianca M. Boxma-de Klerk PhD2, Elmir Omerovic MD3, Péter Andréka MD, PhD1, Géza Fontos MD1, Franz-Josef Neumann, MD4, Gert Richardt, MD, PhD5, Mohammad Abdelghani MD PhD6, Pieter C. Smits, MD, PhD2
1 Department of Cardiology, Gottsegen National Cardiovascular Institute, Budapest, Hungary,
2 Department of Cardiology, Maasstad Ziekenhuis, Rotterdam, The Netherlands,
3 Department of Cardiology, Gothenburg University Hospital, Gothenburg, Sweden,
4 Department of Cardiology, University Heart Center Freiburg– Bad Krozingen, Bad Krozingen, Germany,
5 Department of Cardiology, Heart Center, Segeberger Kliniken, Bad Segeberg, Germany,
6 Amsterdam UMC, University of Amsterdam, The Netherlands

Bemutatás módja

Szóbeli

Szekció

Clinical Medicine I. Lectures

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Aims: We aimed to study the applicability of resting indices to guide non-infarct related artery (nIRA) revascularization in ST-elevation myocardial infarction (STEMI).
Method: We analyzed the correlation and prognostic value of Fractional Flow Reserve (FFR) and resting distal coronary to aortic pressure ratio (Pd/Pa) in all patients of the Compare-Acute trial in whom, after successful primary percutaneous coronary intervention (PCI), the nIRA was interrogated by both and treated medically. The treating cardiologist was blinded to these values. The primary end-point was the composite of target vessel (TV: interrogated nIRA) related non-fatal myocardial infarction (TVMI) and TV repeat revascularization (TVR) at 36 months.
Results: 674 patients (851 vessels) were included. On receiver-operating characteristic analysis, the optimal Pd/Pa cut-off for FFR ≤0.80 was 0.905 (C statistic: 0.897). The diagnostic accuracy of Pd/Pa was 80.26% (95% confidence interval (CI), 77.42-82.88%) with respect to FFR. During the 36-month follow-up, 147 TVR and 20 TVMI occurred. FFR and Pd/Pa had a diagnostic accuracy to predict these events of 68.98% (95% CI, 65.75-72.07%) and 60.99% (95% CI, 57.62-64.28%), respectively (p=0.08). When they were discrepant, FFR was significantly better than Pd/Pa in identifying which vessels could be safely deferred (p=0.018).
Conclusion: Immediately after successful primary PCI, resting Pd/Pa has a diagnostic accuracy of 80% with respect to FFR measured in the nIRA. FFR is not significantly superior in predicting TVMI and TVR during 36 months of follow-up but, in case FFR and Pd/Pa are discrepant, FFR is superior in choosing non-culprit lesions to be deferred.
Funding: The study was supported by the ÚNKP-20-4-II-SE-10 New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund, Hungary.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

None

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4317

Start

09:30

End

09:45

Authors (legacy)

Zsolt Piróth MD PhD1, Gábor Fülöp MD1, Bianca M. Boxma-de Klerk PhD2, Elmir Omerovic MD3, Péter Andréka MD, PhD1, Géza Fontos MD1, Franz-Josef Neumann, MD4, Gert Richardt, MD, PhD5, Mohammad Abdelghani MD PhD6, Pieter C. Smits, MD, PhD2
1 Department of Cardiology, Gottsegen National Cardiovascular Institute, Budapest, Hungary,
2 Department of Cardiology, Maasstad Ziekenhuis, Rotterdam, The Netherlands,
3 Department of Cardiology, Gothenburg University Hospital, Gothenburg, Sweden,
4 Department of Cardiology, University Heart Center Freiburg– Bad Krozingen, Bad Krozingen, Germany,
5 Department of Cardiology, Heart Center, Segeberger Kliniken, Bad Segeberg, Germany,
6 Amsterdam UMC, University of Amsterdam, The Netherlands