Routine Pressure Wire Assessment Versus Conventional Angiography in the Management of Patients With Coronary Artery Disease: The RIPCORD 2 Trial.
In: Circulation, Jg. 146 (2022-08-30), Heft 9, S. 687-698
Online
academicJournal
Zugriff:
Background: Measurement of fractional flow reserve (FFR) has an established role in guiding percutaneous coronary intervention. We tested the hypothesis that, at the stage of diagnostic invasive coronary angiography, systematic FFR-guided assessment of coronary artery disease would be superior, in terms of resource use and quality of life, to assessment by angiography alone. Methods: We performed an open-label, randomized, controlled trial in 17 UK centers, recruiting 1100 patients undergoing invasive coronary angiography for the investigation of stable angina or non-ST-segment-elevation myocardial infarction. Patients were randomized to either angiography alone (angiography) or angiography with systematic pressure wire assessment of all epicardial vessels >2.25 mm in diameter (angiography+FFR). The coprimary outcomes assessed at 1 year were National Health Service hospital costs and quality of life. Prespecified secondary outcomes included clinical events. Results: In the angiography+FFR arm, the median number of vessels examined was 4 (interquartile range, 3-5). The median hospital costs were similar: angiography, £4136 (interquartile range, £2613-£7015); and angiography+FFR, £4510 (£2721-£7415; P=0.137). There was no difference in median quality of life using the visual analog scale of the EuroQol EQ-5D-5L: angiography, 75 (interquartile range, 60-87); and angiography+FFR, 75 (interquartile range, 60-90; P=0.88). The number of clinical events was as follows: deaths, 5 versus 8; strokes, 3 versus 4; myocardial infarctions, 23 versus 22; and unplanned revascularizations, 26 versus 33, with a composite hierarchical event rate of 8.7% (48 of 552) for angiography versus 9.5% (52 of 548) for angiography+FFR (P=0.64). Conclusions: A strategy of systematic FFR assessment compared with angiography alone did not result in a significant reduction in cost or improvement in quality of life. Registration: URL: https://www. Clinicaltrials: gov; Unique identifier: NCT01070771. [ABSTRACT FROM AUTHOR]
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Routine Pressure Wire Assessment Versus Conventional Angiography in the Management of Patients With Coronary Artery Disease: The RIPCORD 2 Trial.
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Autor/in / Beteiligte Person: | Stables, Rodney H. ; Mullen, Liam J. ; Elguindy, Mostafa ; Nicholas, Zoe ; Aboul-Enien, Yousra H. ; Kemp, Ian ; O'Kane, Peter ; Hobson, Alex ; Johnson, Thomas W. ; Khan, Sohail Q. ; Wheatcroft, Stephen B. ; Garg, Scot ; Zaman, Azfar G. ; Mamas, Mamas A. ; Nolan, James ; Jadhav, Sachin ; Berry, Colin ; Watkins, Stuart ; Hildick-Smith, David ; Gunn, Julian |
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Zeitschrift: | Circulation, Jg. 146 (2022-08-30), Heft 9, S. 687-698 |
Veröffentlichung: | 2022 |
Medientyp: | academicJournal |
ISSN: | 0009-7322 (print) |
DOI: | 10.1161/CIRCULATIONAHA.121.057793 |
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