Long-Term Outcomes in Elderly Patients After Deferral of Coronary Revascularization Guided by Fractional Flow Reserve

Background: Little evidence is available regarding the long-term outcome in elderly patients after deferral of revascularization based on fractional flow reserve (FFR).Methods and Results: From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention bas...

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Veröffentlicht in:Circulation Journal 2022/08/25, Vol.86(9), pp.1329-1336
Hauptverfasser: Ueki, Yasushi, Kuramitsu, Shoichi, Saigusa, Tatsuya, Senda, Keisuke, Matsuo, Hitoshi, Horie, Kazunori, Takashima, Hiroaki, Terai, Hidenobu, Kikuta, Yuetsu, Ishihara, Takayuki, Sakamoto, Tomohiro, Suematsu, Nobuhiro, Shiono, Yasutsugu, Asano, Taku, Tsujita, Kenichi, Masamura, Katsuhiko, Doijiri, Tatsuki, Sasaki, Yohei, Ogita, Manabu, Kurita, Tairo, Matsuo, Akiko, Harada, Ken, Yaginuma, Kenji, Kanemura, Noriyoshi, Sonoda, Shinjo, Yokoi, Hiroyoshi, Tanaka, Nobuhiro, on behalf of the J-CONFIRM Investigators
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container_end_page 1336
container_issue 9
container_start_page 1329
container_title Circulation Journal
container_volume 86
creator Ueki, Yasushi
Kuramitsu, Shoichi
Saigusa, Tatsuya
Senda, Keisuke
Matsuo, Hitoshi
Horie, Kazunori
Takashima, Hiroaki
Terai, Hidenobu
Kikuta, Yuetsu
Ishihara, Takayuki
Sakamoto, Tomohiro
Suematsu, Nobuhiro
Shiono, Yasutsugu
Asano, Taku
Tsujita, Kenichi
Masamura, Katsuhiko
Doijiri, Tatsuki
Sasaki, Yohei
Ogita, Manabu
Kurita, Tairo
Matsuo, Akiko
Harada, Ken
Yaginuma, Kenji
Kanemura, Noriyoshi
Sonoda, Shinjo
Yokoi, Hiroyoshi
Tanaka, Nobuhiro
on behalf of the J-CONFIRM Investigators
description Background: Little evidence is available regarding the long-term outcome in elderly patients after deferral of revascularization based on fractional flow reserve (FFR).Methods and Results: From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicenter registry), 1,262 patients were divided into 2 groups according to age: elderly and younger patients (aged ≥75 or
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The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TVMI), and clinically driven target vessel revascularization (CDTVR). Cumulative 5-year incidence of TVF was not significantly different between elderly and younger patients (14.3% vs. 10.8%, P=0.12). Cardiac death occurred more frequently in elderly patients than younger patients (4.4% vs. 0.8%, P&lt;0.001), whereas TVMI and CDTVR did not differ between groups (1.3% vs. 0.9%, P=0.80; 10.7% vs. 10.1%, P=0.80, respectively). FFR values in lesions with diameter stenosis &lt;50% were significantly higher in elderly patients than in younger patients (0.88±0.07 vs. 0.85±0.07, P=0.01), whereas this relationship was not observed in those with diameter stenosis ≥50%.Conclusions: Elderly patients had no excess risk of ischemic events related to the deferred coronary lesions by FFR, although FFR values in mild coronary artery stenosis were modestly different between elderly and younger patients.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-21-1024</identifier><identifier>PMID: 35283368</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Aged ; Chronic coronary syndrome ; Constriction, Pathologic - complications ; Coronary Angiography - adverse effects ; Coronary Artery Disease - complications ; Coronary Stenosis - complications ; Death ; Elderly patients ; Fractional flow reserve ; Fractional Flow Reserve, Myocardial ; Humans ; Myocardial Infarction - etiology ; Myocardial Revascularization - adverse effects ; Revascularization ; Treatment Outcome</subject><ispartof>Circulation Journal, 2022/08/25, Vol.86(9), pp.1329-1336</ispartof><rights>2022, THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c578t-3c535d36f9fedc207c6b32b7f0204ff33482e785298d87950be066ddab8ca9c13</citedby><cites>FETCH-LOGICAL-c578t-3c535d36f9fedc207c6b32b7f0204ff33482e785298d87950be066ddab8ca9c13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,1887,27933,27934</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35283368$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ueki, Yasushi</creatorcontrib><creatorcontrib>Kuramitsu, Shoichi</creatorcontrib><creatorcontrib>Saigusa, Tatsuya</creatorcontrib><creatorcontrib>Senda, Keisuke</creatorcontrib><creatorcontrib>Matsuo, Hitoshi</creatorcontrib><creatorcontrib>Horie, Kazunori</creatorcontrib><creatorcontrib>Takashima, Hiroaki</creatorcontrib><creatorcontrib>Terai, Hidenobu</creatorcontrib><creatorcontrib>Kikuta, Yuetsu</creatorcontrib><creatorcontrib>Ishihara, Takayuki</creatorcontrib><creatorcontrib>Sakamoto, Tomohiro</creatorcontrib><creatorcontrib>Suematsu, Nobuhiro</creatorcontrib><creatorcontrib>Shiono, Yasutsugu</creatorcontrib><creatorcontrib>Asano, Taku</creatorcontrib><creatorcontrib>Tsujita, Kenichi</creatorcontrib><creatorcontrib>Masamura, Katsuhiko</creatorcontrib><creatorcontrib>Doijiri, Tatsuki</creatorcontrib><creatorcontrib>Sasaki, Yohei</creatorcontrib><creatorcontrib>Ogita, Manabu</creatorcontrib><creatorcontrib>Kurita, Tairo</creatorcontrib><creatorcontrib>Matsuo, Akiko</creatorcontrib><creatorcontrib>Harada, Ken</creatorcontrib><creatorcontrib>Yaginuma, Kenji</creatorcontrib><creatorcontrib>Kanemura, Noriyoshi</creatorcontrib><creatorcontrib>Sonoda, Shinjo</creatorcontrib><creatorcontrib>Yokoi, Hiroyoshi</creatorcontrib><creatorcontrib>Tanaka, Nobuhiro</creatorcontrib><creatorcontrib>on behalf of the J-CONFIRM Investigators</creatorcontrib><creatorcontrib>J-CONFIRM Investigators</creatorcontrib><creatorcontrib>on behalf of the J-CONFIRM Investigators</creatorcontrib><title>Long-Term Outcomes in Elderly Patients After Deferral of Coronary Revascularization Guided by Fractional Flow Reserve</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background: Little evidence is available regarding the long-term outcome in elderly patients after deferral of revascularization based on fractional flow reserve (FFR).Methods and Results: From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicenter registry), 1,262 patients were divided into 2 groups according to age: elderly and younger patients (aged ≥75 or &lt;75 years, respectively). The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TVMI), and clinically driven target vessel revascularization (CDTVR). Cumulative 5-year incidence of TVF was not significantly different between elderly and younger patients (14.3% vs. 10.8%, P=0.12). Cardiac death occurred more frequently in elderly patients than younger patients (4.4% vs. 0.8%, P&lt;0.001), whereas TVMI and CDTVR did not differ between groups (1.3% vs. 0.9%, P=0.80; 10.7% vs. 10.1%, P=0.80, respectively). FFR values in lesions with diameter stenosis &lt;50% were significantly higher in elderly patients than in younger patients (0.88±0.07 vs. 0.85±0.07, P=0.01), whereas this relationship was not observed in those with diameter stenosis ≥50%.Conclusions: Elderly patients had no excess risk of ischemic events related to the deferred coronary lesions by FFR, although FFR values in mild coronary artery stenosis were modestly different between elderly and younger patients.</description><subject>Aged</subject><subject>Chronic coronary syndrome</subject><subject>Constriction, Pathologic - complications</subject><subject>Coronary Angiography - adverse effects</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Stenosis - complications</subject><subject>Death</subject><subject>Elderly patients</subject><subject>Fractional flow reserve</subject><subject>Fractional Flow Reserve, Myocardial</subject><subject>Humans</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Revascularization - adverse effects</subject><subject>Revascularization</subject><subject>Treatment Outcome</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEFv1DAQRi0Eou3CnRPykUuKY8eJfaxCt6VaqQiVs-XY45KVE5dx0mr59WS7S3sZj6z3fdI8Qj6V7LzkUnx1PbrteXtT8LIoGa_ekNNSVE1RKc7ePu91oVUlTshZzlvGuGZSvycnQnIlRK1OybxJ431xBzjQ23lyaYBM-5FeRg8Yd_SHnXoYp0wvwgRIv0EARBtpCrRNmEaLO_oTHm12c7TY_13wNNKruffgabeja7Ru_7VE1jE9LWwGfIQP5F2wMcPH47siv9aXd-11sbm9-t5ebAonGzUVwkkhvaiDDuAdZ42rO8G7JjDOqhCEWO6ERkmulVeNlqwDVtfe2045q10pVuTLofcB058Z8mSGPjuI0Y6Q5mx4LZSWDVsUrQg7oA5TzgjBPGA_LPeZkpm9bPMs27Q3hpdmL3uJfD62z90A_iXw3-4CrA_ANk_2Hl4Ai1PvIhwbVW30frw2vwK_LRoYxT_aj5Zi</recordid><startdate>20220825</startdate><enddate>20220825</enddate><creator>Ueki, Yasushi</creator><creator>Kuramitsu, Shoichi</creator><creator>Saigusa, Tatsuya</creator><creator>Senda, Keisuke</creator><creator>Matsuo, Hitoshi</creator><creator>Horie, Kazunori</creator><creator>Takashima, Hiroaki</creator><creator>Terai, Hidenobu</creator><creator>Kikuta, Yuetsu</creator><creator>Ishihara, Takayuki</creator><creator>Sakamoto, Tomohiro</creator><creator>Suematsu, Nobuhiro</creator><creator>Shiono, Yasutsugu</creator><creator>Asano, Taku</creator><creator>Tsujita, Kenichi</creator><creator>Masamura, Katsuhiko</creator><creator>Doijiri, Tatsuki</creator><creator>Sasaki, Yohei</creator><creator>Ogita, Manabu</creator><creator>Kurita, Tairo</creator><creator>Matsuo, Akiko</creator><creator>Harada, Ken</creator><creator>Yaginuma, Kenji</creator><creator>Kanemura, Noriyoshi</creator><creator>Sonoda, Shinjo</creator><creator>Yokoi, Hiroyoshi</creator><creator>Tanaka, Nobuhiro</creator><creator>on behalf of the J-CONFIRM Investigators</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20220825</creationdate><title>Long-Term Outcomes in Elderly Patients After Deferral of Coronary Revascularization Guided by Fractional Flow Reserve</title><author>Ueki, Yasushi ; Kuramitsu, Shoichi ; Saigusa, Tatsuya ; Senda, Keisuke ; Matsuo, Hitoshi ; Horie, Kazunori ; Takashima, Hiroaki ; Terai, Hidenobu ; Kikuta, Yuetsu ; Ishihara, Takayuki ; Sakamoto, Tomohiro ; Suematsu, Nobuhiro ; Shiono, Yasutsugu ; Asano, Taku ; Tsujita, Kenichi ; Masamura, Katsuhiko ; Doijiri, Tatsuki ; Sasaki, Yohei ; Ogita, Manabu ; Kurita, Tairo ; Matsuo, Akiko ; Harada, Ken ; Yaginuma, Kenji ; Kanemura, Noriyoshi ; Sonoda, Shinjo ; Yokoi, Hiroyoshi ; Tanaka, Nobuhiro ; on behalf of the J-CONFIRM Investigators</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c578t-3c535d36f9fedc207c6b32b7f0204ff33482e785298d87950be066ddab8ca9c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Chronic coronary syndrome</topic><topic>Constriction, Pathologic - complications</topic><topic>Coronary Angiography - adverse effects</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Stenosis - complications</topic><topic>Death</topic><topic>Elderly patients</topic><topic>Fractional flow reserve</topic><topic>Fractional Flow Reserve, Myocardial</topic><topic>Humans</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Revascularization - adverse effects</topic><topic>Revascularization</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ueki, Yasushi</creatorcontrib><creatorcontrib>Kuramitsu, Shoichi</creatorcontrib><creatorcontrib>Saigusa, Tatsuya</creatorcontrib><creatorcontrib>Senda, Keisuke</creatorcontrib><creatorcontrib>Matsuo, Hitoshi</creatorcontrib><creatorcontrib>Horie, Kazunori</creatorcontrib><creatorcontrib>Takashima, Hiroaki</creatorcontrib><creatorcontrib>Terai, Hidenobu</creatorcontrib><creatorcontrib>Kikuta, Yuetsu</creatorcontrib><creatorcontrib>Ishihara, Takayuki</creatorcontrib><creatorcontrib>Sakamoto, Tomohiro</creatorcontrib><creatorcontrib>Suematsu, Nobuhiro</creatorcontrib><creatorcontrib>Shiono, Yasutsugu</creatorcontrib><creatorcontrib>Asano, Taku</creatorcontrib><creatorcontrib>Tsujita, Kenichi</creatorcontrib><creatorcontrib>Masamura, Katsuhiko</creatorcontrib><creatorcontrib>Doijiri, Tatsuki</creatorcontrib><creatorcontrib>Sasaki, Yohei</creatorcontrib><creatorcontrib>Ogita, Manabu</creatorcontrib><creatorcontrib>Kurita, Tairo</creatorcontrib><creatorcontrib>Matsuo, Akiko</creatorcontrib><creatorcontrib>Harada, Ken</creatorcontrib><creatorcontrib>Yaginuma, Kenji</creatorcontrib><creatorcontrib>Kanemura, Noriyoshi</creatorcontrib><creatorcontrib>Sonoda, Shinjo</creatorcontrib><creatorcontrib>Yokoi, Hiroyoshi</creatorcontrib><creatorcontrib>Tanaka, Nobuhiro</creatorcontrib><creatorcontrib>on behalf of the J-CONFIRM Investigators</creatorcontrib><creatorcontrib>J-CONFIRM Investigators</creatorcontrib><creatorcontrib>on behalf of the J-CONFIRM Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ueki, Yasushi</au><au>Kuramitsu, Shoichi</au><au>Saigusa, Tatsuya</au><au>Senda, Keisuke</au><au>Matsuo, Hitoshi</au><au>Horie, Kazunori</au><au>Takashima, Hiroaki</au><au>Terai, Hidenobu</au><au>Kikuta, Yuetsu</au><au>Ishihara, Takayuki</au><au>Sakamoto, Tomohiro</au><au>Suematsu, Nobuhiro</au><au>Shiono, Yasutsugu</au><au>Asano, Taku</au><au>Tsujita, Kenichi</au><au>Masamura, Katsuhiko</au><au>Doijiri, Tatsuki</au><au>Sasaki, Yohei</au><au>Ogita, Manabu</au><au>Kurita, Tairo</au><au>Matsuo, Akiko</au><au>Harada, Ken</au><au>Yaginuma, Kenji</au><au>Kanemura, Noriyoshi</au><au>Sonoda, Shinjo</au><au>Yokoi, Hiroyoshi</au><au>Tanaka, Nobuhiro</au><au>on behalf of the J-CONFIRM Investigators</au><aucorp>J-CONFIRM Investigators</aucorp><aucorp>on behalf of the J-CONFIRM Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Outcomes in Elderly Patients After Deferral of Coronary Revascularization Guided by Fractional Flow Reserve</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2022-08-25</date><risdate>2022</risdate><volume>86</volume><issue>9</issue><spage>1329</spage><epage>1336</epage><pages>1329-1336</pages><artnum>CJ-21-1024</artnum><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background: Little evidence is available regarding the long-term outcome in elderly patients after deferral of revascularization based on fractional flow reserve (FFR).Methods and Results: From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicenter registry), 1,262 patients were divided into 2 groups according to age: elderly and younger patients (aged ≥75 or &lt;75 years, respectively). The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TVMI), and clinically driven target vessel revascularization (CDTVR). Cumulative 5-year incidence of TVF was not significantly different between elderly and younger patients (14.3% vs. 10.8%, P=0.12). Cardiac death occurred more frequently in elderly patients than younger patients (4.4% vs. 0.8%, P&lt;0.001), whereas TVMI and CDTVR did not differ between groups (1.3% vs. 0.9%, P=0.80; 10.7% vs. 10.1%, P=0.80, respectively). FFR values in lesions with diameter stenosis &lt;50% were significantly higher in elderly patients than in younger patients (0.88±0.07 vs. 0.85±0.07, P=0.01), whereas this relationship was not observed in those with diameter stenosis ≥50%.Conclusions: Elderly patients had no excess risk of ischemic events related to the deferred coronary lesions by FFR, although FFR values in mild coronary artery stenosis were modestly different between elderly and younger patients.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>35283368</pmid><doi>10.1253/circj.CJ-21-1024</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Chronic coronary syndrome
Constriction, Pathologic - complications
Coronary Angiography - adverse effects
Coronary Artery Disease - complications
Coronary Stenosis - complications
Death
Elderly patients
Fractional flow reserve
Fractional Flow Reserve, Myocardial
Humans
Myocardial Infarction - etiology
Myocardial Revascularization - adverse effects
Revascularization
Treatment Outcome
title Long-Term Outcomes in Elderly Patients After Deferral of Coronary Revascularization Guided by Fractional Flow Reserve
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