Immediate versus staged complete myocardial ...
Type de document :
Compte-rendu et recension critique d'ouvrage
Titre :
Immediate versus staged complete myocardial revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease: a post hoc analysis of the randomized FLOWER-MI trial
Auteur(s) :
Tea, Victoria [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Morelle, Jean-François [Auteur]
Gallet, Romain [Auteur]
Service de Cardiologie [Henri Mondor]
IMRB - "Biologie du système neuromusculaire" [Créteil] [U955 Inserm - UPEC]
Cayla, Guillaume [Auteur]
Centre Hospitalier Universitaire de Nîmes [CHU Nîmes]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Lemesle, Gilles [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Pole Cardio-vasculaire et pulmonaire [CHU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Lhermusier, Thibault [Auteur]
Service Cardiologie [CHU Toulouse]
Université Toulouse III - Paul Sabatier [UT3]
Dillinger, Jean-Guillaume [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Marqueurs cardiovasculaires en situation de stress [MASCOT (UMR_S_942 / U942)]
Ducrocq, Gregory [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Service de Chirurgie Thoracique et Vasculaire [Hôpital Bichat]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Angouvant, Denis [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
CHU Trousseau [Tours]
Cottin, Yves [Auteur]
Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] [PEC2]
Service de Cardiologie [CHU de Dijon]
Chamandi, Chekrallah [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Le Bras, Alicia [Auteur]
Hôpital Hôtel-Dieu [Paris]
Steg, Philippe Gabriel [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Service de Chirurgie Thoracique et Vasculaire [Hôpital Bichat]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Montalescot, Gilles [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Groupe Action
Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [ICAN]
Nelson, Anaïs Charles [Auteur]
CIC - HEGP [CIC 1418]
Simon, Tabassome [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Centre d'investigation clinique Paris Est [CHU Pitié Salpêtrière] [CIC Paris-Est]
Unité de recherche Phytopharmacie et Médiateurs Chimiques [UPMC]
Hémostase, bio-ingénierie et remodelage cardiovasculaires [LBPC (U698)]
Chatellier, Gilles [Auteur]
CIC - HEGP [CIC 1418]
Danchin, Nicolas [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Puymirat, Etienne [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Morelle, Jean-François [Auteur]
Gallet, Romain [Auteur]
Service de Cardiologie [Henri Mondor]
IMRB - "Biologie du système neuromusculaire" [Créteil] [U955 Inserm - UPEC]
Cayla, Guillaume [Auteur]
Centre Hospitalier Universitaire de Nîmes [CHU Nîmes]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Lemesle, Gilles [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Pole Cardio-vasculaire et pulmonaire [CHU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Lhermusier, Thibault [Auteur]
Service Cardiologie [CHU Toulouse]
Université Toulouse III - Paul Sabatier [UT3]
Dillinger, Jean-Guillaume [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Marqueurs cardiovasculaires en situation de stress [MASCOT (UMR_S_942 / U942)]
Ducrocq, Gregory [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Service de Chirurgie Thoracique et Vasculaire [Hôpital Bichat]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Angouvant, Denis [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
CHU Trousseau [Tours]
Cottin, Yves [Auteur]
Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] [PEC2]
Service de Cardiologie [CHU de Dijon]
Chamandi, Chekrallah [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Le Bras, Alicia [Auteur]
Hôpital Hôtel-Dieu [Paris]
Steg, Philippe Gabriel [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Service de Chirurgie Thoracique et Vasculaire [Hôpital Bichat]
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Montalescot, Gilles [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Groupe Action
Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [ICAN]
Nelson, Anaïs Charles [Auteur]
CIC - HEGP [CIC 1418]
Simon, Tabassome [Auteur]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Centre d'investigation clinique Paris Est [CHU Pitié Salpêtrière] [CIC Paris-Est]
Unité de recherche Phytopharmacie et Médiateurs Chimiques [UPMC]
Hémostase, bio-ingénierie et remodelage cardiovasculaires [LBPC (U698)]
Chatellier, Gilles [Auteur]
CIC - HEGP [CIC 1418]
Danchin, Nicolas [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Puymirat, Etienne [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Titre de la revue :
Archives of cardiovascular diseases
Pagination :
496-504
Éditeur :
Elsevier/French Society of Cardiology
Date de publication :
2022-10
ISSN :
1875-2136
Mot(s)-clé(s) en anglais :
Acute myocardial infarction
Fractional flow reserve
Multivessel disease
Fractional flow reserve
Multivessel disease
Discipline(s) HAL :
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
Résumé en anglais : [en]
Background: in patients with ST-segment elevation myocardial infarction and multivessel disease, percutaneous coronary intervention for non-culprit lesions is superior to treatment of the culprit lesion alone. The optimal ...
Lire la suite >Background: in patients with ST-segment elevation myocardial infarction and multivessel disease, percutaneous coronary intervention for non-culprit lesions is superior to treatment of the culprit lesion alone. The optimal timing for non-infarct-related artery revascularization - immediate versus staged - has not been investigated adequately. Aim: we aimed to assess clinical outcomes at 1 year in patients with ST-segment elevation myocardial infarction with multivessel disease using immediate versus staged non-infarct-related artery revascularization. Methods: outcomes were analysed in patients from the randomized FLOWER-MI trial, in whom, after successful primary percutaneous coronary intervention, non-culprit lesions were assessed using fractional flow reserve or angiography during the index procedure or during a staged procedure during the initial hospital stay, ≤5 days after the index procedure. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction and unplanned hospitalization with urgent revascularization at 1 year. Results: among 1171 patients enrolled in this study, 1119 (96.2%) had complete revascularization performed during a staged procedure, and 44 (3.8%) at the time of primary percutaneous coronary intervention. During follow-up, a primary outcome event occurred in one of the patients (2.3%) with an immediate strategy and in 55 patients (4.9%) with a staged strategy (adjusted hazard ratio 1.44, 95% confidence interval 0.39-12.69; P=0.64). Conclusions: staged non-infarct-related artery complete revascularization was the strategy preferred by investigators in practice in patients with ST-segment elevation myocardial infarction with multivessel disease. This strategy was not superior to immediate revascularization, which, in the context of this trial, was used in a small proportion of patients. Further randomized studies are needed to confirm these observational findings.Lire moins >
Lire la suite >Background: in patients with ST-segment elevation myocardial infarction and multivessel disease, percutaneous coronary intervention for non-culprit lesions is superior to treatment of the culprit lesion alone. The optimal timing for non-infarct-related artery revascularization - immediate versus staged - has not been investigated adequately. Aim: we aimed to assess clinical outcomes at 1 year in patients with ST-segment elevation myocardial infarction with multivessel disease using immediate versus staged non-infarct-related artery revascularization. Methods: outcomes were analysed in patients from the randomized FLOWER-MI trial, in whom, after successful primary percutaneous coronary intervention, non-culprit lesions were assessed using fractional flow reserve or angiography during the index procedure or during a staged procedure during the initial hospital stay, ≤5 days after the index procedure. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction and unplanned hospitalization with urgent revascularization at 1 year. Results: among 1171 patients enrolled in this study, 1119 (96.2%) had complete revascularization performed during a staged procedure, and 44 (3.8%) at the time of primary percutaneous coronary intervention. During follow-up, a primary outcome event occurred in one of the patients (2.3%) with an immediate strategy and in 55 patients (4.9%) with a staged strategy (adjusted hazard ratio 1.44, 95% confidence interval 0.39-12.69; P=0.64). Conclusions: staged non-infarct-related artery complete revascularization was the strategy preferred by investigators in practice in patients with ST-segment elevation myocardial infarction with multivessel disease. This strategy was not superior to immediate revascularization, which, in the context of this trial, was used in a small proportion of patients. Further randomized studies are needed to confirm these observational findings.Lire moins >
Langue :
Anglais
Vulgarisation :
Non
Source :
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- j.acvd.2022.05.011
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