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Coronary artery disease and percutaneous coronary intervention in patients with severe chronic kidney disease.
Prog Cardiovasc Dis
January 2025
Department of Cardiology, St Francis Hospital and Heart Center, Roslyn, New York, USA; New York Institute of Technology, Old Westbury, New York, USA. Electronic address:
Coronary artery disease (CAD) is the leading cause of mortality among patients with chronic kidney disease (CKD), presenting unique challenges in diagnosis and management. Advanced CKD patients often present with atypical symptoms, and conventional diagnostic and interventional approaches carry risks, including contrast-induced nephropathy and the potential need for renal replacement therapy. These risks have led to the phenomenon of "renalism," where necessary procedures may be deferred due to concerns over renal injury.
View Article and Find Full Text PDFCoronary revascularisation deferral based on quantitative flow ratio or fractional flow reserve: a post hoc analysis of the FAVOR III Europe trial.
EuroIntervention
January 2025
Hospital Clínico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain and Centro de Investigación Biomédica en Red - Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
Background: Safe deferral of revascularisation is a key aspect of physiology-guided percutaneous coronary intervention (PCI). While recent evidence gathered in the FAVOR III Europe trial showed that quantitative flow ratio (QFR) guidance did not meet non-inferiority to fractional flow reserve (FFR) guidance, it remains unknown if QFR might have a specific value in revascularisation deferral.
Aims: We aimed to evaluate the safety of coronary revascularisation deferral based on QFR as compared with FFR.
The timing of surgical interventions following the implantation of coronary drug-eluting stents in patients undergoing gastrointestinal cancer surgery: a multicenter retrospective cohort study.
Int J Surg
December 2024
Senior Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing, China.
Abstract: We aim to investigate the optimal timing for surgical interventions to maximize patient benefit.
Background: The guidelines recommending a minimum deferral of six months for non-cardiac surgeries following drug-eluting stent percutaneous coronary intervention (DES-PCI) do not adequately address the requirements for individuals undergoing gastrointestinal cancer surgery (GCS).
Methods: The study encompassed 2,501 patients treated from January 2017 to December 2021, all of whom underwent GCS within one year after DES-PCI.
Clinical Relevance of Discordance Between Physiology- and Imaging-Guided PCI Strategies in Intermediate Coronary Stenosis.
JACC Cardiovasc Interv
October 2024
Seoul National University Hospital, Seoul, Republic of Korea. Electronic address:
Article Synopsis
- Recent studies highlight the advantages of using intravascular imaging (IVI) for percutaneous coronary intervention (PCI) compared to traditional angiography, but the relevance of angiography-based physiological assessments during this procedure is not fully understood.
- The FLAVOUR trial analyzed the impact of angiography-based physiological evaluations, specifically the quantitative flow ratio (μQFR), on treatment decisions for patients undergoing IVI-guided PCI.
- Results indicated significant reclassification of treatment approaches based on μQFR, with the REFERENCE group experiencing a higher risk of major adverse cardiovascular events, while DEFER and PERFORM groups showed similar outcomes and quality of life after 2 years.*
Impact of CT-angiography derived plaque characteristics on cardiac events in patients with a negative invasive fractional flow reserve.
Int J Cardiol
February 2025
Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Background: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS) improves outcomes compared with angiography-guided PCI, however cardiac events still occur during long-term follow-up of FFR-negative patients. In the PREVENT study preventive PCI reduced cardiac-events in lesions which were FFR-negative (FFR > 0.80) and had intracoronary imaging defined vulnerable plaque.
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