Comparison of treatment strategy for Multi-Vessel Disease (MVD) patients between conventional angiography and FFR based on SYNTAX score in a real-world scenario
- Conditions
- Health Condition 1: I248- Other forms of acute ischemic heart disease
- Registration Number
- CTRI/2020/09/027770
- Lead Sponsor
- Dr Nattawut Wongpraparut from Faculty of Medicine Siriraj Hospital
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Closed to Recruitment of Participants
- Sex
- Not specified
- Target Recruitment
- 0
1. Age >18 years
2. Willing to participate and able to understand, read and sign the informed consent document before the planned procedure
3. Eligible for coronary angiography and/or percutaneous coronary intervention
4. Stable angina
5. Recent and stabilized NSTEMI
Angiographic inclusion criteria
- Coronary artery disease in two or more native major epicardial vessels or their branches by coronary angiogram with visually assessed de novo coronary stenosis in which one of the lesion has the physiological severity of the lesion is in question (typically 50-90% diameter stenosis)
- All lesions are amenable to revascularizationÂ
- Terminal disease with life expectancy of less than 12 months
- Any patient who at the time of planned angiography has ongoing ischemic symptoms
- Angiography performed in the context of primary PCI of STEMI
- Acute coronary syndrome with difficulty in assessing the culprit lesion
- Pregnancy
- Severe aortic stenosis
- Significant valvular heart disease indicated for concomitant valve surgery
- Cardiogenic shock or hemodynamic instability
- Contraindication to adenosine
- Previous CABG
- Additional investigations planned for the assessment of myocardial viability.
- Severe asthma
Angiographic exclusion criteria
- Heavily calcified or tortuous vessels that in the opinion of the investigator would result in uncrossable of pressure wire
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Change in treatment strategy after physiologic assessment <br/ ><br> <br/ ><br>Healthcare costs <br/ ><br>Timepoint: In-hospital and at 1 year
- Secondary Outcome Measures
Name Time Method The percentage rate of concordance between FFR and RFRÂ <br/ ><br> <br/ ><br>Procedural time <br/ ><br>Level of agreement in the decision-making strategy based on invasive angiography and physiologic assessment <br/ ><br>Functional SYNTAX score calculation based on FFR <br/ ><br> <br/ ><br>Composite of MACCE (all-cause death, documented myocardial infarction, stroke or unplanned revascularization) <br/ ><br> <br/ ><br>Rates of individual components of MACE <br/ ><br> <br/ ><br>Change in health status of patients from baselineTimepoint: IN-Hospital, 30 days and 1 year