Forskning ved Københavns Universitet - Københavns Universitet


Fractional Flow Reserve Guided PCI in Patients With and Without Left Ventricular Hypertrophy: a DANAMI-3-PRIMULTI Sub-study

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AIMS: To investigate the correlation between fractional flow reserve (FFR) and diameter stenosis in patients with STEMI with and without left ventricular hypertrophy (LVH), and the influence of LVH on complete FFR-guided revascularization versus culprit only, in terms of risk of clinical outcome.

METHODS AND RESULTS: In this DANAMI-3-PRIMULTI sub-study, 279 patients with STEMI had cardiac magnetic resonance (CMR) for assessment of left-ventricular-mass-index. Ninety-six patients had FFR evaluation of a non-culprit lesion. Diameter stenosis of the non-culprit lesion was determined with 2-dimensional quantitative-coronary-analysis. The diameter stenosis (56.9% vs. 54.3%, p=0.38) and FFR value (0.83 vs. 0.85, p=0.34) were significantly correlated in both groups (Spearmans ρ=-0.40 and -0.41 without LVH and with LVH, respectively; p<0.001) but was not different between patients without and with LVH (p for interaction =0.87). FFR-guided complete revascularization was associated with reduced risk of death, myocardial infarction or ischemia-driven revascularization for both patients without LVH (HR 0.42, 95%CI 0.20-0.85) and for patients with LVH (HR 0.50, 95%CI 0.17-0.47), with no interaction between the FFR-guided complete revascularization and LVH (p for interaction =0.82).

CONCLUSIONS: LVH did not interact with the correlation between diameter stenosis and FFR and did not modify the impact of complete revascularization on the occurrence of subsequent clinical events.

StatusE-pub ahead of print - 2020

ID: 238483166