Navigation Links
Efficacy of stents is improved when their placement is determined by arterial blood flow measurement

Reperfusion therapy in the form of percutaneous coronary intervention (PCI) is now the recommended first treatment for victims of acute myocardial infarction. New European guidelines issued in November 2008 emphasised speed of action and the importance of reperfusion therapy to restore blood flow to the heart and improve survival rates. The benefits of PCI are less clear in patients with stable coronary artery disease; PCI has been shown to improve symptoms, but the impact on prognosis is still a matter of debate.

The cornerstone of PCI is the technique of angioplasty, by which either bare-metal or drug-releasing stents are located within the coronary arteries at points of occlusion. The FAME study, reported in the 15 January issue of the New England Journal of Medicine, was a randomised trial designed to assess the most effective method of locating the stent in patients with multivessel disease: conventional angiography (visualisation of the artery) or a new technique of "fractional flow reserve" (FFR), by which a tiny wire with a sensor is threaded through the coronary artery to the point of occlusion and blood flow measured to determine if the lesion is restricting blood flow and causing ischemia.(1)

The study, conducted in 20 European and US centres, randomised more than 1000 patients with multivessel coronary disease to either of the two methods for placement of stents. Results showed that one-third fewer stents were used in the FFR group and the difference in composite outcome at one year was significant: the FFR group showed a 28% lower incidence of major adverse cardiac events (repeat angioplasty, heart attack or death) - 18.3% vs. 13.2%.

The implication in these results is that placing stents in lesions not responsible for ischemia is not only unnecessary, but may cause worse outcomes.

Commenting on the study on behalf of the European Society of Cardiology, Professor Uwe Zeymer from the Herzzentrum, Ludwigshafen, Germany, said that, while PCI is clearly beneficial for the relief of symptoms in patients with stable angina, the prognostic impact of PCI in the patient group in this study is still a matter of debate. One reason for this, he explained, may be that some stent procedures are performed solely on the basis of "oculo stenotic reflex" (the visual presence of a stenosis).

However, he added: "One method which is easy to perform and readily available during diagnostic angiography is measurement of the fractional flow reserve, a method which can distinguish between hemodynamically relevant and irrelevant stenoses. The latter do not need intervention and can be safely treated with medical therapy. The FAME study has now shown that by using FFR we can improve the prognosis of patients and reduce the number of unnecessary interventions. As a result, this method should be used in patients with stable symptoms and without documentation of ischemia by another method. In patients with multivessel disease in particular, FFR can increase the safety and efficacy of coronary revascularisation. In addition, FFR seems cost effective and avoids unnecessary and potentially harmful interventions."


Contact: ESC Press Office
European Society of Cardiology

Related medicine news :

1. Senesco Announces Results of Pre-Clinical Efficacy, Toxicology and Dose Ranging Studies for Multiple Myeloma Therapeutic Candidate
2. SCOLR Pharma, Inc. Announces Positive Top-Line Results From Pivotal Clinical Trial Evaluating Efficacy of Extended-Release Ibuprofen
3. New Analyses Confirm Nexavars Efficacy and Safety in Multiple Patient Subsets With Liver Cancer
4. WVU study demonstrates efficacy of CT perfusion in diagnosis of acute ischemic stroke
5. Topical treatment for cold sores achieves efficacy of oral drugs; represents paradigm shift
6. Enbrel(R) (etanercept) Is the First Biologic With Published Efficacy and Safety Data for up to a Decade of Continuous Use for the Treatment of Moderate to Severe Rheumatoid Arthritis
7. Accuracy, efficacy and ethics of abstinence-only programs questioned by public health experts
8. Head-to-Head 96-Week Study Shows EPZICOM(R) is Comparable to Truvada(R) in Efficacy and Safety Measures in HIV Treatment-Naive Patients
9. Overcoming inhibitors of cell death improves cancer therapy efficacy
10. New Long-Term HUMIRA(R) (adalimumab) Data Show Up to Seven-Year Efficacy with Combination Treatment for Rheumatoid Arthritis
11. A Drug With Efficacy Superior to That of Remicade at Inducing Closure and Healing of Fistulas Would Earn a 30 Percent Patient Share in the Crohns Disease Drug Market
Post Your Comments:
(Date:11/30/2015)... , ... November 30, 2015 , ... RoamRight, a leading ... with Public Television’s Travel With Kids to promote family vacations around ... family as they explore international destinations and educate families about the people and places ...
(Date:11/30/2015)... ... November 30, 2015 , ... Advocare Orthopedic ... orthopedic care. Led by John Vitolo, M.D., the center offers their patients ... team at Advocare Orthopedic & Sports Medicine is ready to help their patients ...
(Date:11/30/2015)... ... November 30, 2015 , ... International telepathology consultations ... and KingMed Diagnostics researchers. Their review of more than 1,500 ... UPMC pathologists resulted in significantly altered treatment plans for more than half of ...
(Date:11/30/2015)... ... November 30, 2015 , ... The American Society for Clinical Pathology (ASCP) announced ... Day 2015. On Nov. 30, ASCP shared its “Give a minute. Get tested. Find ... and the importance of getting tested for HIV. , ASCP has asked members to ...
(Date:11/30/2015)... ... ... An inventor from Charlottesville, Va., is concerned about the need for peace and ... due to loud noises," she said, "so I decided that there needs to be ... radio waves and microwaves." , The baby BABY MUFF prevents loud noises, radio waves ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... Texas , Nov. 30, 2015  Hanger, Inc. ... amendment and restatement of the terms of its previously ... Solicitation") relating to its $200,000,000 aggregate principal amount 7⅛% ... other things, (i) the consent fees payable pursuant to ... on the Notes and (iii) the expiration date of ...
(Date:11/30/2015)... NAMUR , Belgium , Nov. 30, ... life sciences company focused on developing blood-based diagnostic tests for ... announced the Company will present at the LD Micro Conference, ... Los Angeles, CA. Attending from VolitionRx will ... and Scott Powell , Vice President of Investor Relations. ...
(Date:11/30/2015)... , November 30, 2015 PFE ... at up to 10 G protein-coupled receptor (GPCR) targets ... to research and develop potential new medicines directed at ... multiple therapeutic areas. --> Heptares Therapeutics ("Heptares"), ... and wholly-owned subsidiary of Sosei Group Corporation ("Sosei"; TSE ...
Breaking Medicine Technology: