Diagnosis and Treatment of Ischemia-Producing Coronary Stenoses Improves 5-year Survival of Patients Undergoing Major Vascular Surgery.
Peripheral artery disease
coronary CT-derived fractional flow reserve
ischemia-guided coronary revascularization
long-term survival
major vascular surgery
silent coronary ischemia
Journal
Journal of vascular surgery
ISSN: 1097-6809
Titre abrégé: J Vasc Surg
Pays: United States
ID NLM: 8407742
Informations de publication
Date de publication:
20 Mar 2024
20 Mar 2024
Historique:
received:
26
01
2024
revised:
22
02
2024
accepted:
24
02
2024
medline:
23
3
2024
pubmed:
23
3
2024
entrez:
22
3
2024
Statut:
aheadofprint
Résumé
Patients undergoing vascular surgery procedures have poor long-term survival due to coexisting coronary artery disease (CAD) which is often asymptomatic, undiagnosed and undertreated. We sought to determine whether pre-operative diagnosis of asymptomatic (silent) coronary ischemia using coronary CT -derived fractional flow reserve (FFR In this observational cohort study of 522 patients with no known CAD undergoing elective carotid, peripheral or aneurysm surgery we compared two groups of patients. Group I: 288 patients enrolled in a prospective IRB-approved study of pre-operative coronary CTA and FFR The two groups were similar in age, gender, and comorbidities. In FFR Diagnosis of silent coronary ischemia with ischemia-targeted coronary revascularization in addition to BMT following major vascular surgery was associated with fewer adverse cardiovascular events and improved 5-year survival compared patients treated with BMT alone as per current guidelines.
Sections du résumé
BACKGROUND
BACKGROUND
Patients undergoing vascular surgery procedures have poor long-term survival due to coexisting coronary artery disease (CAD) which is often asymptomatic, undiagnosed and undertreated. We sought to determine whether pre-operative diagnosis of asymptomatic (silent) coronary ischemia using coronary CT -derived fractional flow reserve (FFR
METHODS
METHODS
In this observational cohort study of 522 patients with no known CAD undergoing elective carotid, peripheral or aneurysm surgery we compared two groups of patients. Group I: 288 patients enrolled in a prospective IRB-approved study of pre-operative coronary CTA and FFR
RESULTS
RESULTS
The two groups were similar in age, gender, and comorbidities. In FFR
CONCLUSIONS
CONCLUSIONS
Diagnosis of silent coronary ischemia with ischemia-targeted coronary revascularization in addition to BMT following major vascular surgery was associated with fewer adverse cardiovascular events and improved 5-year survival compared patients treated with BMT alone as per current guidelines.
Identifiants
pubmed: 38518962
pii: S0741-5214(24)00500-7
doi: 10.1016/j.jvs.2024.02.043
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.