AIMS: The aim of this study was to assess prospectively the clinical benefits of fractional flow reserve (FFR) in guiding coronary artery bypass grafting (CABG). METHODS AND RESULTS: GRAFFITI is a single-blinded, prospective, multicentre, randomised controlled trial of FFR-guided versus angiography-guided CABG. We enrolled patients undergoing coronary angiography, having a significantly diseased left anterior descending artery or left main stem and at least one more major coronary artery with intermediate stenosis, assessed by FFR. Surgical strategy was defined based on angiography, blinded to FFR values prior to randomisation. After randomisation, patients were operated on either following the angiography-based strategy (angiography-guided group) or according to FFR, i.e., with an FFR ≤0.80 as cut-off for grafting (FFR-guided group). The primary endpoint was graft patency at 12 months. Between March 2012 and December 2016, 172 patients were randomised either to the angiography-guided group (84 patients) or to the FFR-guided group (88 patients). The patients had a median of three [3; 4] lesions; diameter stenosis was 65% (50%; 80%), FFR was 0.72 (0.50; 0.82). Compared to the angiography-guided group, the FFR-guided group received fewer anastomoses (3 [3; 3] vs 2 [2; 3], respectively; p=0.004). One-year angiographic follow-up showed no difference in overall graft patency (126 [80%] vs 113 [81%], respectively; p=0.885). One-year clinical follow-up, available in 98% of patients, showed no difference in the composite of death, myocardial infarction, target vessel revascularisation and stroke. CONCLUSIONS:FFR guidance of CABG has no impact on one-year graft patency, but it is associated with a simplified surgical procedure. ClinicalTrials.gov Identifier: NCT01810224.
RCT Entities:
AIMS: The aim of this study was to assess prospectively the clinical benefits of fractional flow reserve (FFR) in guiding coronary artery bypass grafting (CABG). METHODS AND RESULTS: GRAFFITI is a single-blinded, prospective, multicentre, randomised controlled trial of FFR-guided versus angiography-guided CABG. We enrolled patients undergoing coronary angiography, having a significantly diseased left anterior descending artery or left main stem and at least one more major coronary artery with intermediate stenosis, assessed by FFR. Surgical strategy was defined based on angiography, blinded to FFR values prior to randomisation. After randomisation, patients were operated on either following the angiography-based strategy (angiography-guided group) or according to FFR, i.e., with an FFR ≤0.80 as cut-off for grafting (FFR-guided group). The primary endpoint was graft patency at 12 months. Between March 2012 and December 2016, 172 patients were randomised either to the angiography-guided group (84 patients) or to the FFR-guided group (88 patients). The patients had a median of three [3; 4] lesions; diameter stenosis was 65% (50%; 80%), FFR was 0.72 (0.50; 0.82). Compared to the angiography-guided group, the FFR-guided group received fewer anastomoses (3 [3; 3] vs 2 [2; 3], respectively; p=0.004). One-year angiographic follow-up showed no difference in overall graft patency (126 [80%] vs 113 [81%], respectively; p=0.885). One-year clinical follow-up, available in 98% of patients, showed no difference in the composite of death, myocardial infarction, target vessel revascularisation and stroke. CONCLUSIONS: FFR guidance of CABG has no impact on one-year graft patency, but it is associated with a simplified surgical procedure. ClinicalTrials.gov Identifier: NCT01810224.
Authors: Dario Tino Bertolone; Emanuele Gallinoro; Giuseppe Esposito; Pasquale Paolisso; Konstantinos Bermpeis; Cristina De Colle; Davide Fabbricatore; Niya Mileva; Chiara Valeriano; Daniel Munhoz; Marta Belmonte; Marc Vanderheyden; Jozef Bartunek; Jeroen Sonck; Eric Wyffels; Carlos Collet; Costantino Mancusi; Carmine Morisco; Nicola De Luca; Bernard De Bruyne; Emanuele Barbato Journal: High Blood Press Cardiovasc Prev Date: 2022-02-11
Authors: Cong Chen; Yang Zhao; Wei Li; Kui Zhang; Haiming Dang; Taoshuai Liu; Yue Song; Jubing Zheng; Ran Dong Journal: Front Cardiovasc Med Date: 2022-09-06
Authors: Gabor G Toth; Carlos Collet; Anne Langhoff Thuesen; Takuya Mizukami; Filip Casselman; Lars Peter Riber; Frank Van Praet; Anders Junker; Sakura Nagumo; Bernard De Bruyne; Lisette Okkels Jensen; Emanuele Barbato Journal: Catheter Cardiovasc Interv Date: 2021-07-07 Impact factor: 2.585