Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus

Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive...
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Autor*in:	Kennedy, Mark W. [verfasserIn] Kaplan, Eliza Hermanides, Rik S. Fabris, Enrico Hemradj, Veemal Koopmans, Petra C. Dambrink, Jan-Hank E. Marcel Gosselink, A. T. van‘t Hof, Arnoud W. J. Ottervanger, Jan Paul Roolvink, Vincent Remkes, Wouter S. van der Sluis, Aize Suryapranata, Harry Kedhi, Elvin

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2016

Schlagwörter:	Diabetes mellitus Fractional flow reserve Deferred revascularisation Target lesion failure Target lesion revascularisation

Anmerkung:	© The Author(s) 2016

Übergeordnetes Werk:	Enthalten in: Cardiovascular diabetology - London : BioMed Central, 2002, 15(2016), 1 vom: 19. Juli
Übergeordnetes Werk:	volume:15 ; year:2016 ; number:1 ; day:19 ; month:07

Links:	Volltext

DOI / URN:	10.1186/s12933-016-0417-2

Katalog-ID:	SPR028546733

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100	1		\|a Kennedy, Mark W. \|e verfasserin \|4 aut
245	1	0	\|a Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus
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520			\|a Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown.
650		4	\|a Diabetes mellitus \|7 (dpeaa)DE-He213
650		4	\|a Fractional flow reserve \|7 (dpeaa)DE-He213
650		4	\|a Deferred revascularisation \|7 (dpeaa)DE-He213
650		4	\|a Target lesion failure \|7 (dpeaa)DE-He213
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700	1		\|a Kaplan, Eliza \|4 aut
700	1		\|a Hermanides, Rik S. \|4 aut
700	1		\|a Fabris, Enrico \|4 aut
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700	1		\|a Koopmans, Petra C. \|4 aut
700	1		\|a Dambrink, Jan-Hank E. \|4 aut
700	1		\|a Marcel Gosselink, A. T. \|4 aut
700	1		\|a van‘t Hof, Arnoud W. J. \|4 aut
700	1		\|a Ottervanger, Jan Paul \|4 aut
700	1		\|a Roolvink, Vincent \|4 aut
700	1		\|a Remkes, Wouter S. \|4 aut
700	1		\|a van der Sluis, Aize \|4 aut
700	1		\|a Suryapranata, Harry \|4 aut
700	1		\|a Kedhi, Elvin \|4 aut
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allfields	10.1186/s12933-016-0417-2 doi (DE-627)SPR028546733 (SPR)s12933-016-0417-2-e DE-627 ger DE-627 rakwb eng Kennedy, Mark W. verfasserin aut Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2016 Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown. Diabetes mellitus (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Deferred revascularisation (dpeaa)DE-He213 Target lesion failure (dpeaa)DE-He213 Target lesion revascularisation (dpeaa)DE-He213 Kaplan, Eliza aut Hermanides, Rik S. aut Fabris, Enrico aut Hemradj, Veemal aut Koopmans, Petra C. aut Dambrink, Jan-Hank E. aut Marcel Gosselink, A. T. aut van‘t Hof, Arnoud W. J. aut Ottervanger, Jan Paul aut Roolvink, Vincent aut Remkes, Wouter S. aut van der Sluis, Aize aut Suryapranata, Harry aut Kedhi, Elvin aut Enthalten in Cardiovascular diabetology London : BioMed Central, 2002 15(2016), 1 vom: 19. Juli (DE-627)356593665 (DE-600)2093769-6 1475-2840 nnns volume:15 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s12933-016-0417-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2016 1 19 07
spelling	10.1186/s12933-016-0417-2 doi (DE-627)SPR028546733 (SPR)s12933-016-0417-2-e DE-627 ger DE-627 rakwb eng Kennedy, Mark W. verfasserin aut Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2016 Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown. Diabetes mellitus (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Deferred revascularisation (dpeaa)DE-He213 Target lesion failure (dpeaa)DE-He213 Target lesion revascularisation (dpeaa)DE-He213 Kaplan, Eliza aut Hermanides, Rik S. aut Fabris, Enrico aut Hemradj, Veemal aut Koopmans, Petra C. aut Dambrink, Jan-Hank E. aut Marcel Gosselink, A. T. aut van‘t Hof, Arnoud W. J. aut Ottervanger, Jan Paul aut Roolvink, Vincent aut Remkes, Wouter S. aut van der Sluis, Aize aut Suryapranata, Harry aut Kedhi, Elvin aut Enthalten in Cardiovascular diabetology London : BioMed Central, 2002 15(2016), 1 vom: 19. Juli (DE-627)356593665 (DE-600)2093769-6 1475-2840 nnns volume:15 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s12933-016-0417-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2016 1 19 07
allfields_unstemmed	10.1186/s12933-016-0417-2 doi (DE-627)SPR028546733 (SPR)s12933-016-0417-2-e DE-627 ger DE-627 rakwb eng Kennedy, Mark W. verfasserin aut Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2016 Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown. Diabetes mellitus (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Deferred revascularisation (dpeaa)DE-He213 Target lesion failure (dpeaa)DE-He213 Target lesion revascularisation (dpeaa)DE-He213 Kaplan, Eliza aut Hermanides, Rik S. aut Fabris, Enrico aut Hemradj, Veemal aut Koopmans, Petra C. aut Dambrink, Jan-Hank E. aut Marcel Gosselink, A. T. aut van‘t Hof, Arnoud W. J. aut Ottervanger, Jan Paul aut Roolvink, Vincent aut Remkes, Wouter S. aut van der Sluis, Aize aut Suryapranata, Harry aut Kedhi, Elvin aut Enthalten in Cardiovascular diabetology London : BioMed Central, 2002 15(2016), 1 vom: 19. Juli (DE-627)356593665 (DE-600)2093769-6 1475-2840 nnns volume:15 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s12933-016-0417-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2016 1 19 07
allfieldsGer	10.1186/s12933-016-0417-2 doi (DE-627)SPR028546733 (SPR)s12933-016-0417-2-e DE-627 ger DE-627 rakwb eng Kennedy, Mark W. verfasserin aut Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2016 Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown. Diabetes mellitus (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Deferred revascularisation (dpeaa)DE-He213 Target lesion failure (dpeaa)DE-He213 Target lesion revascularisation (dpeaa)DE-He213 Kaplan, Eliza aut Hermanides, Rik S. aut Fabris, Enrico aut Hemradj, Veemal aut Koopmans, Petra C. aut Dambrink, Jan-Hank E. aut Marcel Gosselink, A. T. aut van‘t Hof, Arnoud W. J. aut Ottervanger, Jan Paul aut Roolvink, Vincent aut Remkes, Wouter S. aut van der Sluis, Aize aut Suryapranata, Harry aut Kedhi, Elvin aut Enthalten in Cardiovascular diabetology London : BioMed Central, 2002 15(2016), 1 vom: 19. Juli (DE-627)356593665 (DE-600)2093769-6 1475-2840 nnns volume:15 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s12933-016-0417-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2016 1 19 07
allfieldsSound	10.1186/s12933-016-0417-2 doi (DE-627)SPR028546733 (SPR)s12933-016-0417-2-e DE-627 ger DE-627 rakwb eng Kennedy, Mark W. verfasserin aut Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2016 Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown. Diabetes mellitus (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Deferred revascularisation (dpeaa)DE-He213 Target lesion failure (dpeaa)DE-He213 Target lesion revascularisation (dpeaa)DE-He213 Kaplan, Eliza aut Hermanides, Rik S. aut Fabris, Enrico aut Hemradj, Veemal aut Koopmans, Petra C. aut Dambrink, Jan-Hank E. aut Marcel Gosselink, A. T. aut van‘t Hof, Arnoud W. J. aut Ottervanger, Jan Paul aut Roolvink, Vincent aut Remkes, Wouter S. aut van der Sluis, Aize aut Suryapranata, Harry aut Kedhi, Elvin aut Enthalten in Cardiovascular diabetology London : BioMed Central, 2002 15(2016), 1 vom: 19. Juli (DE-627)356593665 (DE-600)2093769-6 1475-2840 nnns volume:15 year:2016 number:1 day:19 month:07 https://dx.doi.org/10.1186/s12933-016-0417-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2016 1 19 07
language	English
source	Enthalten in Cardiovascular diabetology 15(2016), 1 vom: 19. Juli volume:15 year:2016 number:1 day:19 month:07
sourceStr	Enthalten in Cardiovascular diabetology 15(2016), 1 vom: 19. Juli volume:15 year:2016 number:1 day:19 month:07
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Diabetes mellitus Fractional flow reserve Deferred revascularisation Target lesion failure Target lesion revascularisation
isfreeaccess_bool	true
container_title	Cardiovascular diabetology
authorswithroles_txt_mv	Kennedy, Mark W. @@aut@@ Kaplan, Eliza @@aut@@ Hermanides, Rik S. @@aut@@ Fabris, Enrico @@aut@@ Hemradj, Veemal @@aut@@ Koopmans, Petra C. @@aut@@ Dambrink, Jan-Hank E. @@aut@@ Marcel Gosselink, A. T. @@aut@@ van‘t Hof, Arnoud W. J. @@aut@@ Ottervanger, Jan Paul @@aut@@ Roolvink, Vincent @@aut@@ Remkes, Wouter S. @@aut@@ van der Sluis, Aize @@aut@@ Suryapranata, Harry @@aut@@ Kedhi, Elvin @@aut@@
publishDateDaySort_date	2016-07-19T00:00:00Z
hierarchy_top_id	356593665
id	SPR028546733
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR028546733</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230520012817.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201007s2016 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s12933-016-0417-2</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR028546733</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12933-016-0417-2-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Kennedy, Mark W.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2016</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s) 2016</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Diabetes mellitus</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Fractional flow reserve</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Deferred revascularisation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Target lesion failure</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Target lesion revascularisation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Kaplan, Eliza</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Hermanides, Rik S.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Fabris, Enrico</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Hemradj, Veemal</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Koopmans, Petra C.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Dambrink, Jan-Hank E.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Marcel Gosselink, A. 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author	Kennedy, Mark W.
spellingShingle	Kennedy, Mark W. misc Diabetes mellitus misc Fractional flow reserve misc Deferred revascularisation misc Target lesion failure misc Target lesion revascularisation Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus
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topic_title	Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus Diabetes mellitus (dpeaa)DE-He213 Fractional flow reserve (dpeaa)DE-He213 Deferred revascularisation (dpeaa)DE-He213 Target lesion failure (dpeaa)DE-He213 Target lesion revascularisation (dpeaa)DE-He213
topic	misc Diabetes mellitus misc Fractional flow reserve misc Deferred revascularisation misc Target lesion failure misc Target lesion revascularisation
topic_unstemmed	misc Diabetes mellitus misc Fractional flow reserve misc Deferred revascularisation misc Target lesion failure misc Target lesion revascularisation
topic_browse	misc Diabetes mellitus misc Fractional flow reserve misc Deferred revascularisation misc Target lesion failure misc Target lesion revascularisation
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title	Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus
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title_full	Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus
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author_browse	Kennedy, Mark W. Kaplan, Eliza Hermanides, Rik S. Fabris, Enrico Hemradj, Veemal Koopmans, Petra C. Dambrink, Jan-Hank E. Marcel Gosselink, A. T. van‘t Hof, Arnoud W. J. Ottervanger, Jan Paul Roolvink, Vincent Remkes, Wouter S. van der Sluis, Aize Suryapranata, Harry Kedhi, Elvin
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title_sort	clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus
title_auth	Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus
abstract	Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown. © The Author(s) 2016
abstractGer	Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown. © The Author(s) 2016
abstract_unstemmed	Objective Deferred revascularisation based upon fractional flow reserve (FFR >0.80) is associated with a low incidence of target lesion failure (TLF). Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. Whether intravascular imaging, additional invasive haemodynamics or stringent risk factor modification may impact on this higher TLF rate remains unknown. © The Author(s) 2016
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title_short	Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus
url	https://dx.doi.org/10.1186/s12933-016-0417-2
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author2	Kaplan, Eliza Hermanides, Rik S. Fabris, Enrico Hemradj, Veemal Koopmans, Petra C. Dambrink, Jan-Hank E. Marcel Gosselink, A. T. van‘t Hof, Arnoud W. J. Ottervanger, Jan Paul Roolvink, Vincent Remkes, Wouter S. van der Sluis, Aize Suryapranata, Harry Kedhi, Elvin
author2Str	Kaplan, Eliza Hermanides, Rik S. Fabris, Enrico Hemradj, Veemal Koopmans, Petra C. Dambrink, Jan-Hank E. Marcel Gosselink, A. T. van‘t Hof, Arnoud W. J. Ottervanger, Jan Paul Roolvink, Vincent Remkes, Wouter S. van der Sluis, Aize Suryapranata, Harry Kedhi, Elvin
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Whether deferred revascularisation is also as safe in diabetes mellitus (DM) patients is unknown. Methods All DM patients and the next consecutive Non-DM patients who underwent a FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/07/2015. Patients with lesions FFR >0.80 were analysed according to the presence vs. absence of DM, while patients who underwent index revascularisation in FFR-assessed or other lesions were excluded. The primary endpoint was the incidence of TLF; a composite of target lesion revascularisation (TLR) and target vessel myocardial infarction (TVMI). Results A total of 250 patients (122 DM, 128 non-DM) who underwent deferred revascularisation of all lesions (FFR >0.80) were compared. At a mean follow up of 39.8 ± 16.3 months, DM patients compared to non-DM had a higher TLF rate, 18.1 vs 7.5 %, logrank p ≤ 0.01, Cox regression-adjusted HR 3.65 (95 % CI 1.40–9.53, p < 0.01), which was largely driven by a higher incidence of TLR (17.2 vs. 7.5 %, HR 3.52, 95 % CI 1.34–9.30, p = 0.01), whilst a non-significant but numerically higher incidence of TVMI (6.1 vs. 2.0 %, HR 3.34, 95 % CI 0.64–17.30, p = 0.15) was observed. Conclusions This study, the largest to directly compare the clinical outcomes of FFR-guided deferred revascularisation in patients with and without DM, shows that DM patients are associated with a significantly higher TLF rate. 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Clinical outcomes of deferred revascularisation using fractional flow reserve in patients with and without diabetes mellitus

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