Publication
Nonculprit Stenosis Evaluation Using Instantaneous Wave-Free Ratio in Patients With ST-Segment Elevation Myocardial Infarction.
| dc.contributor.author | Thim, T | |
| dc.contributor.author | Gotberg, M | |
| dc.contributor.author | Frobert, O | |
| dc.contributor.author | Nijveldt, R | |
| dc.contributor.author | van Royen, N | |
| dc.contributor.author | Baptista, SB | |
| dc.contributor.author | Koul S, et al. | |
| dc.date.accessioned | 2018-04-12T10:12:17Z | |
| dc.date.available | 2018-04-12T10:12:17Z | |
| dc.date.issued | 2017 | |
| dc.description.abstract | OBJECTIVES: The aim of this study was to examine the level of agreement between acute instantaneous wave-free ratio (iFR) measured across nonculprit stenoses in patients with ST-segment elevation myocardial infarction (STEMI) and iFR measured at a staged follow-up procedure. BACKGROUND: Acute full revascularization of nonculprit stenoses in STEMI is debated and currently guided by angiography. Acute functional assessment of nonculprit stenoses may be considered. METHODS: Immediately after successful primary culprit intervention for STEMI, nonculprit coronary stenoses were evaluated with iFR and left untreated. Follow-up evaluation with iFR was performed at a later stage. iFR <0.90 was considered hemodynamically significant. RESULTS: One hundred twenty patients with 157 nonculprit lesions were included. Median acute iFR was 0.89 (interquartile range [IQR]: 0.82 to 0.94; n = 156), and median follow-up iFR was 0.91 (interquartile range: 0.86 to 0.96; n = 147). Classification agreement was 78% between acute and follow-up iFR. The negative predictive value of acute iFR was 89%. Median time from acute to follow-up evaluation was 16 days (IQR: 5 to 32 days). With follow-up within 5 days after STEMI, no difference was observed between acute and follow-up iFR, and classification agreement was 89%. With follow-up ≥16 days after STEMI, acute iFR was lower than follow-up iFR, and classification agreement was 70%. CONCLUSIONS: Acute iFR evaluation appeared valid for ruling out significant nonculprit stenoses in patients with STEMI undergoing primary percutaneous coronary intervention. The time interval from acute to follow-up iFR influenced classification agreement, suggesting that inherent physiological disarrangements during STEMI may contribute to classification disagreement. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | JACC Cardiovasc Interv. 2017 Dec 26;10(24):2528-2535. | pt_PT |
| dc.identifier.doi | 10.1016/j.jcin.2017.07.021 | pt_PT |
| dc.identifier.issn | 1876-7605 | |
| dc.identifier.uri | http://hdl.handle.net/10400.10/1984 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier | pt_PT |
| dc.subject | Myocardial infarction | pt_PT |
| dc.subject | Myocardial revascularization | pt_PT |
| dc.title | Nonculprit Stenosis Evaluation Using Instantaneous Wave-Free Ratio in Patients With ST-Segment Elevation Myocardial Infarction. | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.conferencePlace | New York | pt_PT |
| oaire.citation.endPage | 2535 | pt_PT |
| oaire.citation.startPage | 2528 | pt_PT |
| oaire.citation.title | Journal of the American College of Cardiology cardiovascular interventions | pt_PT |
| oaire.citation.volume | 10 | pt_PT |
| rcaap.rights | closedAccess | pt_PT |
| rcaap.type | article | pt_PT |