@article{169a497feff145ef91e01b1f366a06dd,
title = "Fractional flow reserve and quality-of-life improvement after percutaneous coronary intervention in patients with stable coronary artery disease",
abstract = "BACKGROUND: Whether the benefit in quality of life (QOL) after percutaneous coronary intervention depends on the severity of the stenosis as determined by fractional flow reserve (FFR) remains unknown. This study sought to investigate the relationship between FFR values and improvement in QOL. METHODS: From the FAME 1 and 2 trials (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation), we identified 706 stable patients with coronary artery disease who had at least 1 lesion with an FFR≤0.80 that was treated with percutaneous coronary intervention and 185 patients with coronary artery disease who had no lesion with an FFR≤0.80 and were treated medically who served as a reference group. QOL was assessed by the European Quality of Life-5 Dimensions index at baseline, 1 month, and 1 year. We assessed the relationship between QOL improvement (defined as the change in European Quality of Life-5 Dimensions index from baseline) and FFR as a continuous value and according to abnormal FFR tertile. RESULTS: QOL improved significantly after percutaneous coronary intervention in each abnormal FFR tertile, whereas it did not change in the reference group. The lowest abnormal FFR subgroup had the greatest improvement in QOL at 1 month (P<0.001). In mixed-effects models for repeated measures, lower FFR (P=0.002 for 1 month and 0.049 for 1 year), greater delta FFR (P=0.021 for 1 month and 0.025 for 1 year), and higher angina class (P=0.001 for 1 month and < 0.001 for 1 year) were associated with the greatest magnitude of QOL improvement at both 1 month and 1 year. CONCLUSIONS: Among patients with stable coronary artery disease, FFR and angina severity predict QOL improvement after percutaneous coronary intervention.",
keywords = "Fractional flow reserve, Myocardial, Percutaneous coronary intervention, Quality of life",
author = "Takeshi Nishi and Zsolt Piroth and {De Bruyne}, Bernard and Nikola Jagic and Sven M{\"o}bius-Winkler and Yuhei Kobayashi and Fran{\c c}ois Derimay and Stephane Fournier and Emanuele Barbato and Pim Tonino and Peter Juni and Pijls, {Nico H.J.} and Fearon, {William F.}",
note = "Funding Information: FAME 1 was supported by Radi Medical Systems, Stichting Vrienden van het Hart Zuidoost Brabant, and Medtronic. FAME 2 was supported by St. Jude Medical. The present substudy was not supported by any additional industrial funding or research grant. Funding Information: Dr De Bruyne declares that the Cardiovascular Center Aalst receives on his behalf grant support from Abbott, Boston Scientific, Biotronik, and St. Jude Medical and consulting fees from St. Jude Medical, Opsens, and Boston Scientific. He is a shareholder for Siemens, GE, Bayer, Philips, Heartflow, Edwards Life-Sciences, Sanofi, and Omega Pharma. Dr Kobayashi receives an institutional fellowship grant from Boston Scientific. Dr Fournier reports grants from the Swiss National Science Foundation. Dr Barbato declares that the Cardiovascular Center Aalst receives on his behalf grant support from Abbott, Boston Scientific, Biotronik, and St. Jude Medical and consulting fees from St. Jude Medical and Boston Scientific. Dr Pijls is a consultant for St. Jude Medical, Inc, Opsens, Inc, and Boston Scientific, Inc and is a shareholder for Philips, Inc, ASML, Inc, General Electrics, Inc, and Heartflow, Inc. Dr J{\"u} eceived research grants to the institution from AstraZeneca, Biotronik, Biosensors International, Eli Lilly, and The Medicines Company and serves as an unpaid member of the steering group of trials funded by AstraZeneca, Biotronik, Biosensors, St. Jude Medical, and The Medicines Company. Dr Fearon reports institutional research support from Medtronic, Abbott Vascular, ACIST Medical, CathWorks, and Edwards LifeSciences. He has a consulting relationship with Boston Scientific and Heart-Flow. The other authors report no conflicts. Publisher Copyright: {\textcopyright} 2018 American Heart Association, Inc. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",
year = "2018",
doi = "10.1161/CIRCULATIONAHA.118.035263",
language = "English (US)",
volume = "138",
pages = "1797--1804",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "17",
}