Ahmed, N. et al. (2016) Safety of guidewire-based measurement of fractional flow reserve and the index of microvascular resistance using intravenous adenosine in patients with acute or recent myocardial infarction. International Journal of Cardiology, 202, pp. 305-310. (doi: 10.1016/j.ijcard.2015.09.014) (PMID:26418191) (PMCID:PMC4669307)
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Abstract
Aims: Coronary guidewire-based diagnostic assessments with hyperemia may cause iatrogenic complications. We assessed the safety of guidewire-based measurement of coronary physiology, using intravenous adenosine, in patients with an acute coronary syndrome. Methods: We prospectively enrolled invasively managed STEMI and NSTEMI patients in two simultaneously conducted studies in 6 centers (NCT01764334; NCT02072850). All of the participants underwent a diagnostic coronary guidewire study using intravenous adenosine (140 μg/kg/min) infusion for 1–2 min. The patients were prospectively assessed for the occurrence of serious adverse events (SAEs) and symptoms and invasively measured hemodynamics were also recorded. Results: 648 patients (n = 298 STEMI patients in 1 hospital; mean time to reperfusion 253 min; n = 350 NSTEMI in 6 hospitals; median time to angiography from index chest pain episode 3 (2, 5) days) were included between March 2011 and May 2013. Two NSTEMI patients (0.03% overall) experienced a coronary dissection related to the guidewire. No guidewire dissections occurred in the STEMI patients. Chest symptoms were reported in the majority (86%) of patient's symptoms during the adenosine infusion. No serious adverse events occurred during infusion of adenosine and all of the symptoms resolved after the infusion ceased. Conclusions: In this multicenter analysis, guidewire-based measurement of FFR and IMR using intravenous adenosine was safe in patients following STEMI or NSTEMI. Self-limiting symptoms were common but not associated with serious adverse events. Finally, coronary dissection in STEMI and NSTEMI patients was noted to be a rare phenomenon.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Carrick, Dr David and Hood, Dr Stuart and Eteiba, Professor Hany and McConnachie, Professor Alex and Petrie, Professor Mark and Oldroyd, Dr Keith and Layland, Dr Jamie and Berry, Professor Colin |
Authors: | Ahmed, N., Layland, J., Carrick, D., Petrie, M. C., McEntegart, M., Eteiba, H., Hood, S., Lindsay, M., Watkins, S., Davie, A., Mahrous, A., Carberry, J., Teng, V., McConnachie, A., Curzen, N., Oldroyd, K. G., and Berry, C. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | International Journal of Cardiology |
Publisher: | Elsevier Ireland Ltd. |
ISSN: | 0167-5273 |
ISSN (Online): | 1874-1754 |
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