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 , ... According to Los Angeles bariatric surgeon ... are not necessarily caused by real hunger, but instead by a hormone called ... notes that, while many patients are aware that weight loss surgery can help patients ...
(Date:11/30/2015)... ... November 30, 2015 , ... RoamRight, a leading provider of ... Public Television’s Travel With Kids to promote family vacations around the world. ... they explore international destinations and educate families about the people and places of the ...
(Date:11/30/2015)... ... 30, 2015 , ... At Grand Dental PC, their priority is to deliver ... have dental problems, you need to turn to a dentist who listens and responds; ... needs, a friendly dentist who counsels you on the best ways to maintain and ...
(Date:11/30/2015)... ... ... Newly reviewed and approved “NJ Top Dentist”, Paul Dionne, ... both advanced training and considerable experience in reconstructive dentistry with attention to occlusal ... He is an active Spear Education member providing full mouth restorative and ...
(Date:11/30/2015)... ... ... ”Dying Words: The AIDS Reporting of Jeff Schmalz and How It Transformed ... World AIDS Day. The multi-media project will be in audio documentary form with a ... dying of the disease. , A collaborative effort led by author, professor and journalist ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... 30, 2015 Oramed Pharmaceuticals Inc. (NASDAQ: ... development of oral drug delivery systems, announced today it ... to $50,000,000 with Hefei Tianhui Incubator of Technologies Co., Ltd. ("HTIT") ... ORMD-0801, in China , ... . The agreements were signed at the Israel Knesset ...
(Date:11/30/2015)... -- Cumberland Pharmaceuticals (CPIX), today announced that A.J. Kazimi , ... 3, 2015. TIME: 3:15p.m. ET LINK: ... --> DATE: Thursday, December 3, ... --> --> This will be ... ask the company questions in real-time - both in the ...
(Date:11/30/2015)... , Nov. 30, 2015   Nuance Communications, ... The National Decision Support Company (NDSC) today jointly ... and collaboration capabilities that utilize the American College of ... healthcare provider organizations to comply with current and ... --> --> By combining clinical decision ...
Breaking Medicine Technology: