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Optimal Prognostication of Patients with Coronary Stenoses in the Pre- and Post-PCI setting: Comments on TARGET FFR and DEFINE-FLOW Trials Presented at TCT Connect 2020.冠状动脉狭窄患者在经皮冠状动脉介入治疗前后的最佳预后评估：对在2020年TCT Connect会议上发表的TARGET FFR和DEFINE-FLOW试验的评论
Eur Cardiol. 2021 Apr 27;16:e17. doi: 10.15420/ecr.2021.04. eCollection 2021 Feb.
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引用本文的文献

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Coronary Physiology: Modern Concepts for the Guidance of Percutaneous Coronary Interventions and Medical Therapy.冠状动脉生理学：用于指导经皮冠状动脉介入治疗和药物治疗的现代概念
J Clin Med. 2023 Mar 15;12(6):2274. doi: 10.3390/jcm12062274.

本文引用的文献

1
Prognostic Impact of Residual Anatomic Disease Burden After Functionally Complete Revascularization.功能完全血运重建后残余解剖学疾病负担的预后影响
Circ Cardiovasc Interv. 2020 Sep;13(9):e009232. doi: 10.1161/CIRCINTERVENTIONS.120.009232. Epub 2020 Sep 8.
2
Prognostic Implications of Post-Intervention Resting Pd/Pa and Fractional Flow Reserve in Patients With Stent Implantation.支架植入术后静息Pd/Pa及血流储备分数的预后意义
JACC Cardiovasc Interv. 2020 Aug 24;13(16):1920-1933. doi: 10.1016/j.jcin.2020.05.042.
3
Role of Post-Stent Physiological Assessment in a Risk Prediction Model After Coronary Stent Implantation.支架置入术后生理评估在冠状动脉支架置入术后风险预测模型中的作用。
JACC Cardiovasc Interv. 2020 Jul 27;13(14):1639-1650. doi: 10.1016/j.jcin.2020.04.041.
4
Objective Identification of Intermediate Lesions Inducing Myocardial Ischemia Using Sequential Intracoronary Pressure and Flow Measurements.目的：利用序贯冠状动脉内压力和血流测量识别引起心肌缺血的中间病变。
J Am Heart Assoc. 2020 Jul 7;9(13):e015559. doi: 10.1161/JAHA.119.015559. Epub 2020 Jun 23.
5
Non-hyperaemic coronary pressure measurements to guide coronary interventions.非高血运状态下的冠状动脉压力测量指导冠状动脉介入治疗。
Nat Rev Cardiol. 2020 Oct;17(10):629-640. doi: 10.1038/s41569-020-0374-z. Epub 2020 May 14.
6
Initial Invasive or Conservative Strategy for Stable Coronary Disease.稳定型冠心病的初始侵入性或保守治疗策略。
N Engl J Med. 2020 Apr 9;382(15):1395-1407. doi: 10.1056/NEJMoa1915922. Epub 2020 Mar 30.
7
Distal Evaluation of Functional performance with Intravascular sensors to assess the Narrowing Effect-combined pressure and Doppler FLOW velocity measurements (DEFINE-FLOW) trial: Rationale and trial design.血管内传感器的远端功能性能评估以评估狭窄效应-联合压力和多普勒血流速度测量（DEFINE-FLOW）试验：原理和试验设计。
Am Heart J. 2020 Apr;222:139-146. doi: 10.1016/j.ahj.2019.08.018. Epub 2019 Sep 1.
8
A randomized controlled trial of a physiology-guided percutaneous coronary intervention optimization strategy: Rationale and design of the TARGET FFR study.一项基于生理学的经皮冠状动脉介入优化策略的随机对照试验：TARGET FFR 研究的原理和设计。
Clin Cardiol. 2020 May;43(5):414-422. doi: 10.1002/clc.23342. Epub 2020 Feb 10.
9
Contribution of Age-Related Microvascular Dysfunction to Abnormal Coronary: Hemodynamics in Patients With Ischemic Heart Disease.年龄相关性微血管功能障碍对缺血性心脏病患者冠状动脉异常血流动力学的影响。
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Int J Cardiol. 2020 Mar 1;302:34-35. doi: 10.1016/j.ijcard.2019.12.040. Epub 2019 Dec 20.

冠状动脉狭窄患者在经皮冠状动脉介入治疗前后的最佳预后评估：对在2020年TCT Connect会议上发表的TARGET FFR和DEFINE-FLOW试验的评论

Optimal Prognostication of Patients with Coronary Stenoses in the Pre- and Post-PCI setting: Comments on TARGET FFR and DEFINE-FLOW Trials Presented at TCT Connect 2020.

作者信息

Seitz Andreas, Baumann Stefan, Sechtem Udo, Ong Peter

机构信息

Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus Stuttgart, Germany.

Department of Cardiology, Pneumology and Angiology, University Hospital Mannheim Mannheim, Germany.

出版信息

Eur Cardiol. 2021 Apr 27;16:e17. doi: 10.15420/ecr.2021.04. eCollection 2021 Feb.

DOI:10.15420/ecr.2021.04
PMID:33995587
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8117135/
Abstract

The body of evidence for the use of coronary physiology assessments to guide percutaneous coronary intervention (PCI) has been growing continuously in recent decades. Two studies presented during TCT Connect 2020 added insights into the prognostic value of coronary physiology measurements in pre- and post-PCI settings. The first study, TARGET FFR, assessed whether a post-PCI fractional flow reserve (FFR)-guided incremental optimisation strategy (PIOS) was superior to angiography-guided PCI. The second study, DEFINE-FLOW, assessed the course of stenoses with fractional and coronary flow reserve (FFR+/CFR-) discordance when treated medically. This article summarises the main results from the TARGET FFR and the DEFINE-FLOW trials and puts them into the context of the existing literature.

摘要

近几十年来，使用冠状动脉生理学评估来指导经皮冠状动脉介入治疗（PCI）的证据一直在不断增加。在2020年TCT Connect会议上发表的两项研究，为冠状动脉生理学测量在PCI术前和术后环境中的预后价值提供了新的见解。第一项研究，TARGET FFR，评估了PCI术后基于血流储备分数（FFR）引导的增量优化策略（PIOS）是否优于血管造影引导的PCI。第二项研究，DEFINE-FLOW，评估了药物治疗时存在血流储备分数与冠状动脉血流储备不一致（FFR+/CFR-）的狭窄病变的病程。本文总结了TARGET FFR和DEFINE-FLOW试验的主要结果，并将其置于现有文献的背景中。