Is it the Time to Move Towards Coronary Computed Tomography
Angiography-Derived Fractional Flow Reserve Guided Percutaneous Coronary
Intervention? The Pros and Cons

Sharifkazemi, Mohammadbagher; Hooshanginezhad, Zahra; Zoroufian, Arezou; Shamsa, Kamran

doi:10.2174/1573403x19666230119115228

CCR

2023

DOI: 10.2174/1573403x19666230119115228

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Is it the Time to Move Towards Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve Guided Percutaneous Coronary Intervention? The Pros and Cons

Mohammadbagher Sharifkazemi

Zahra Hooshanginezhad

Arezou Zoroufian

et al.

Abstract: Coronary artery disease is the leading cause of mortality worldwide. Diagnosis is conventionally performed by direct visualization of the arteries by invasive coronary angiography (ICA), which has inherent limitations and risks. Measurement of fractional flow reserve (FFR) has been suggested for a more accurate assessment of ischemia in the coronary artery with high accuracy for determining the severity and decision on the necessity of intervention. Nevertheless, invasive coronary angiography-derived fraction… Show more

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Cited by 2 publications

References 111 publications

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Urban cyclists’ perception of risk using body and environmental monitoring

Abdolrazaghi,

Mirbaha

2024

Proceedings of the Institution of Civil Engineers - Municipal E

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There is limited information on the influence of environmental and behavioural factors on cyclists’ risk perception. This study gives insights into the factors shaping cyclists’ perception of risk. Twenty-six cyclists were assessed for their psychological distress and previous cycling experience, following which their heart rate was monitored while cycling along a variety of urban routes. The findings are that cycling through commercial areas, one-way routes, and routes with speed limits reduced their perceived risk. However, wider cycling routes and bikeways were associated with an increased heart rate. This study implied that both individual and environmental characteristics significantly influence risk perception. Both the psychological well-being of cyclists and cycling infrastructure should be considered to promote urban cycling. Risk perception serves as an indicator to guide the development of urban cycling facilities, enabling urban planners and policymakers to promote healthier, more sustainable cities through effective promotion of cycling for urban commuting.

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Urban cyclists’ perception of risk using body and environmental monitoring

Abdolrazaghi,

Mirbaha

2024

Proceedings of the Institution of Civil Engineers - Municipal E

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Clinical, Angiographic and Functional Parameters Determining Decision to Perform Revascularization in Stable Coronary Artery Disease Patients With Intermediate Coronary Lesions

Stan,

Mikhaliev,

Zharinov

et al. 2023

Clin. and prev. med.

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The aim: to study the clinical, angiographic and functional parameters, and their relation to the decision on percutaneous coronary intervention (PCI) in stable coronary artery disease (CAD) patients with intermediate coronary stenoses (ІСS) at patient and lesion levels. Materials and methods. The cross-sectional study enrolled 123 patients (62±9 years; 73,2 % males) with stable CAD and angiographically ICS (50-90 %). Stable angina CCS class II (CCSII) was diagnosed in 70 (56,9 %) patients, class III (CCSIII) – 29 (23,6 %); 24 (19,5 %) patients were free from angina (Afree). Fractional flow reserve (FFR) was assessed in 74 (60,2 %) patients (min per patient). The hemodynamically significant lesion was considered if FFR ≤0,80 a.u. The decision to perform PCI was undertaken in 93 (76 %) patients. In addition, the functional data from 128 lesions were analyzed. Results. The CCSIII group was characterized by less frequent previous PCI (21 % vs. 46 % in the pooled group [CCSII + Afree]; р=0,018); the predominance of cases with (max) severe [70-90 %] coronary stenosis (96 % vs. 78 % in CCSII and 54 % in Afree; ptrend<0,001); the lower (min) FFR ([median, quartiles] 0,70 (0,64-0,74) vs. 0,87 (0,81-0,90) in Afree; p˂0,002); and the decision to perform PCI in the vast majority of cases (93 % vs. 79 % in CCSII and 46 % in Afree; ptrend<0,001). The Afree/CCSII/CCSIII groups demonstrated a trend towards a decrease in frequency of cases with (max) [60-69 %] stenosis (38 %, 13 % and none, respectively; ptrend<0,001), and a tendency towards the cases with (max) [80-90 %] stenosis to be more prevalent (29 %, 39 % and 55 %, respectively; ptrend=0,051). The frequency of cases with (max) stenosis [70-79 %] was comparable in the studied groups (Afree/CCSII/CCSIII: 25 %/39 %/41 %, respectively [ptrend=0,240]). At lesion-level, all [80-90 %] lesions (n=28) appeared to be hemodynamically significant. In turn, the [60-69 %] lesions (n=24) included 5 (21 %) significant ones. Finally, the [70-79 %] lesions (n=44) included 28 (64 %) significant and 16 (36 %) non-significant ones. Conclusions. Among the stable CAD patients with angiographically ICS, those with CCSIII were characterized by less frequent previous PCI, significant decrease in FFR and the decision to perform index PCI in the vast majority of cases. There is a need for more precise diagnosis and assessment of myocardial ischemia in patients with an intermediate pre-test obstructive CAD probability, including the cases of previously performed PCI.

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Is it the Time to Move Towards Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve Guided Percutaneous Coronary Intervention? The Pros and Cons

Cited by 2 publications

References 111 publications

Urban cyclists’ perception of risk using body and environmental monitoring

Urban cyclists’ perception of risk using body and environmental monitoring

Clinical, Angiographic and Functional Parameters Determining Decision to Perform Revascularization in Stable Coronary Artery Disease Patients With Intermediate Coronary Lesions

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