Opsens Newsletter

NEWSLETTER HIGHLIGHTS

In this SCAI & EuroPCR edition: FFR in STEMI, we present you with a case report on FFR in STEMI; access to new publications with results from COMPARE-ACUTE and DANAMI-3-PRIMULTI trials; an interview with Dr. Peter Smits; and slides from Dr. Thomas Engstroem, 

We also share FFR highlights at the upcoming SCAI, May 10-13 and EuroPCR, May 16-19; and provide a list of FFR abstracts presented at ACC (March 17-19).

CONTENTS:

  • CASE REPORT 
  • PUBLICATION
  • EXPERT CORNER
  • SLIDE SHARE
  • CONFERENCE COVERAGE
  • MESSAGE FROM CLAUDE BELLEVILLE
  • ABOUT OPSENS
  • DISCOVER OPTOWIRE

CASE REPORT

Is FFR Reliable in STEMI?


Factors including timing of recovery of the coronary microcirculation post-MI, how to avoid false-negative FFR, and diagnostic gaps between schema and plaque vulnerability are discussed.    

Ref: Leite L, et al. BMC Cardiovascular Disorders 2015;15:127.


PUBLICATION

FFR in Acute STEMI - Which Patients Benefit Most?

Primary results of the DANAMI 3-PRIMULTI trial showed that FFR-guided staged treatment of functionally significant non culprit lesions improved outcomes. A new analysis, however, shows that the reduction is seen only in patients with 3VD + a non culprit lesion of 90% or more.

Ref:  Lønborg J, et al. CIrc Cardiovascular Interv. 2017:10:e004460.
Link to journal


EXPERT CORNER

Dr. Peter Smits discusses COMPARE-ACUTE and why PCI in acute STEMI should be guided by FFR


Peter C. Smits, MD, PhD

Department of Cardiology
Maasstad Hospital, Rotterdam, the Netherlands
​ 
Read more...


SLIDE SHARE

Dr. Engstroem shares his slides on DANAMI 3-PRIMULTI primary results and recently reported results of a substudy: FFR in STEMI improves outcomes

Link to slides: Primary results ACC LBT 2015.
Link to slides: Circ Cardiovasc Interv 2017;10(4):e004460 [online April 12].


CONFERENCE COVERAGE

SCAI 2017 
(Society of Cardiovascular Angiography and Interventions) 
May 10-13, New Orleans
Visit Opsens at booth #205:

Learn how OptoWire Deux is setting the new standard in pressure guidewire performance and versatility!

Welcome to a complimentary dinner symposium:
Applying Advanced Physiology Technology in the New PCI Era
Sponsored by Opsens
Thursday May 11, 2017
Dinner 7:15 PM, Program 7:30-9:00 PM

Hilton New Orleans Riverside, Room: St. James (3rd Level) 
Two Poydras Street, New Orleans, LA

AGENDA
7:30 pm  - Intro to New Technology for FFR/iFR (Dr. Morton J. Kern)
7:45 pm  - Left Main Disease: Easy to Say, Hard to Do (Right)  (Dr. Ziad Ali)
8:00 pm  - Think Twice, Cut Once: Best Practices for Bifurcations (Dr. Allen Jeremias)
8:15 pm  - Acute STEMI Patients With MVD: Do All, Do One, Do FFR? (Dr. Ryan Reeves)
8:30 pm  - Post-PCI FFR: It's Not Over 'Til It's Really Over (FFR) (Dr. Barry Uretsky)
8:45 pm  - New Technologies: Where to Next? (Q/A & panel discussion)
9:00 pm  - Adjourn

SCAI 2017 Scientific Sessions:
FFR Highlights

THURSDAY, MAY 11, 2017 

Presentation:  8:00 AM - 8:30 AM - Grand Balloorrom B-C
Hildner Lecture 
Interventional Coronary Physiology - A 30-Year Overnight Success Story - Morton J. Kern, MD, MSCAI

Session:  11:00 AM - Noon - Grand Ballroom A

Coronary Imaging and Physiology

11:00 AM | FFR: When and How - A Case-Based Presentation
11:10 AM | Advanced FFR: Interpreting FFR in Complex Situations
11:20 AM | IVUS: When and How - A Case-Based Presentation
11:30 AM | OCT: When and How - A Case-Based Presentation
11:40 AM | Coronary Imaging and Physiology: Which Test for Which Patient?

11:50 AM | Discussion

Session:  1:00 PM - 6:30 PM - Exhibit Hall, Grand Salon C
Abstract Poster Presentation Sessions
Imaging:  CT, MR, and Non-Invasive Imaging.  Intravascculart Imaging (IVUSW/OCT/Other) and Physiology (FFR/iFR/IMR/Other).

FRIDAY, MAY 12, 2017

Session: 1:30 PM - 3:00 PM - Churhill B1
Cath Lab Boot Camp: Mini-Debates: Make the Business Case - I Should Have This Technology in the Lab 
2:20 PM | Imaging and Physiologic Assessment: Can We Afford All of These Options? - Mazen S. Abu-Fadel

Session: 4:00 PM - 5:30 PM - Fulton
Advanced Symposium for Cardiovascular Professionals
4:00 PM | IVUS, NIRS, FFR, and OCT - Michael J. Lim

SATURDAY, MAY 13, 2017 

Session:  8:00 AM - 8:55 AM - Churchill C2
Comprehensive Heart Team Technology Workshop:
Intermediate Lesions: When Angiography Is Not Enough
8:15 AM | FFR: A Case-Based Presentation
8:30 AM | Hands-On Workshop 1 

Link to SCAI website
Link to Catheterization and Cardiovascular Interventions SCAI abstracts supplement.


EuroPCR 2017 

May 16-19 2017 Paris, France
Visit Opsens at booth #M60

Learn how OptoWire Deux is setting the new standard in pressure guidewire performance and versatility!

EuroPCR 2017 Scientific Sessions
FFR Highlights

TUES 11:30 -12:50 Main Arena
Late-breaking trials and trial update
12:10 PM
Safety of coronary revascularisation deferral based on iFR and FFR measurements in stable angina and acute coronary syndromes. A pooled patient-level analysis of DEFINE FLAIR and IFR SWEDEHEART trials - J. Escaned

EuroPCR 2017 

May 16-19 2017 Paris, France
Visit Opsens at booth #M60

Learn how OptoWire Deux is setting the new standard in pressure guidewire performance and versatility!

EuroPCR 2017 Scientific Sessions
FFR Highlights

TUES 11:30 -12:50 Main Arena
Late-breaking trials and trial update
12:10 PM
Safety of coronary revascularisation deferral based on iFR and FFR measurements in stable angina and acute coronary syndromes. A pooled patient-level analysis of DEFINE FLAIR and IFR SWEDEHEART trials - J. Escaned

TUES 13:45 -15:15 Room 353
Novel Strategies for CTO Recanalization
15:03
The physiological impact of coronary CTO PCI on donor vessel coronary pressure-derived measurement and the influence of collateral circulation - S. Mohdnazri
 
TUES 15:30 -17:00 Room 342B
FFR: think beyond stenosis

WEDS 10:30 -12:00 Room 352B
Eyes can lie: turn on the pressure and resist the oculo-stenotic reflex!

WEDS 10:30 -12:00 Room Arlequin
Renal Interventions for Resistant Hypertension
10:52 Renal FFR to guide percutaneous intervention in double left renal artery - A.C. Zago
 
WEDS 12:30 -13:30 Room Ternes 1
FFR and diagnostic dilemma

WEDS 12:45 -14:30 Room Maillot
Complex Patients with Multi Vessel Disease - FROM Triage of Patient to Treatment: The Future is Now
 
WEDS 12:45 -14:15 Room Ternes 2
PCR's Got Talent Round 1 - Session 1:
13:35 Invasive hyperemic microvascular resistance predicts adverse clinical outcome and microvascular injury after AMI and is superior to coronary flow reserve: a patient-level pooled analysis - G. De Waard
13:39 Separate assessment of hyperaemic epicardial and microvascular conductance using coronary pressure and flow velocity - N. Van der Hoeven
13:43 Additive prognostic value of IVUS parameters to assess clinical outcomes in patients with FFR-guided deferred coronary lesions: up to five-year follow-up - Y.K. Cho
13:47 Correlation between iFR and FFR measurements and its impact on the long-term outcome - J. Bil
13:51 How do intermediate coronary lesions evolve over time? A morphological and functional retrospective, longitudinal study of 414 stenoses - P. Xaplanteris
13:55 Angiography vs. haemodynamic assessment to predict the natural history of coronary stenoses: an FFR vs. angiography in multivessel evaluation 2 (FAME 2) substudy - G. Ciccarelli
14:03 The influence of collateral regression post-coronary CTO PCI on donor vessel coronary pressure-derived measurements - S. Mohdnazri

WEDS 13:35 -14:35 Room 343
Planned and ongoing clinical trials on coronary interventions and imaging
13:35 The FULL REVASC trial - FFR-guidance for complete non-culprit revascularisation: a registry-based randomised clinical trial - F. Böhm

WEDS 14:45 -16:15 Room 251
Imaging and functional measurement from the nurses’ and allied professionals’ perspective.

WEDS 14:45 -16:15 Room 351
FFR: trials and new techniques

14:45 Intracoronary vs intravenous infusion of adenosine for the accurate assessment of fractional flow reserve: the hyperemic study - A. Elghamaz
15:03 Randomised comparison of simultaneous data from 2 different pressure wires: the COMET trial - N. Curzen
15:21 Primary results of the assessment of catheter-based interrogation and standard techniques for fractional flow reserve measurement (ACIST-FFR) study - M. Price
15:39 Pressure wire compared with microcatheter-based evaluation of coronary fractional flow reserve measurements (PERFORM) - Z. Ali
15:57 Pressure wire vs. microcatheter for FFR measurement: a head-to-head comparison - C. Pouillot

WEDS 16:30 -18:00 Room 252A
Will Define-Flair and iFR Swedeheart change my practice: iFR instead of FFR?

THURS 08:30-10:00 Room 343A
Coronary physiology - novel concepts and novel techniques

THURS 08:30 -10:00 Room Maillot
PCI: procedural techniques and clinical outcomes
09:22 Routine fractional flow reserve measurement after PCI the FFR-search study – R. Diletti
 
THURS 08:30 -10:00 THEATRE BLEU
All you need to know about coronary physiology in 2017

THURS 09:45 -10:45 Main Arena
Late-breaking trials and trial update
09:45 FFR guided complete revascularisation during primary angioplasty is cost saving: results from the COMPARE-ACUTE trial – E. Omerovic

THURS 14:45 -16:15 Room 343
New frontiers for coronay physiology
 
FRI 10:30 -12:00 Room 252A
Will COMPARE Acute change my practice?

Link to EuroPCR website
Link to EuroInterveention EuroPCR abstracts supplement.


ACC 2017 

March 18-21, 2017 Washington, DC 

Coronary Physiology Summary

Late-Breaking Clinical Trials and Highlighted Research at ACC included the following FFR-related studies:

  • COMPARE-ACUTE 
    Dr Peter Smits reported improved outcomes with FFR-guided PCI in STEMI (manuscript in NEJM).
  • DEFINE-FLAIR and  iFR-SWEDEHEART  
    Drs Justin Davies and Mattias Gotberg reported non inferiority of iFR to FFR (manuscript in NEJM)
  • MR-INFORM  
    Dr E Nagel reconfirmed the role of stress testing as an alternative to angiography plus FFR for guiding management decisions

The following abstracts were presented and published in the Journal of the American College of Cardiology Vol. 69, Issue 11, Suppl. Pages 1-2569 (21 March 2017).

THE PREDICTIVE VALUE OF MICROVASCULAR DEFECTS OBSERVED DURING DEMAND STRESS MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY AND QUANTITATIVE MEASUREMENTS OF STENOSIS AND MICROVASCULAR RESISTANCE OBTAINED DURING INVASIVE HEMODYNAMICS
Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 

Link to ACC Website
Link to ACC Abstracts

  1. ANATOMIC VERSUS ISCHEMIC BURDEN IN PREDICTING OUTCOMES OF CORONARY ARTERY DISEASE: DATA FROM IRIS-FFR REGISTRY
    Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1055
    Doyoon Kang, et al.
  2. DECISION MAKING USING FRACTIONAL FLOW RESERVE IS ASSOCIATED WITH LOWER RATES OF INCOMPLETE REVASCULARIZATION COMPARED WITH ANGIOGRAPHIC GUIDED DECISION MAKING AMONGST PATIENTS WITH NSTEMI
    Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1057
    Jamie John Layland, et al.
    1. DOES POST PCI FFR CARRY THE SAME PROGNOSTIC WEIGHT AS NON-ISCHEMIC FFR IN DEFERRED LESIONS?
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1176
      Mohammed Eid Madmani, et al.
    1. APPROPRIATENESS OF CORONARY ARTERY BYPASS GRAFTING BASED ON FRACTIONAL FLOW RESERVE LESIONS ASSESSMENT
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1061
      Samer Mansour, et al.
    1. OUTCOMES OF FRACTIONAL FLOW RESERVE BASED DEFERRAL IN SAPHENOUS VEIN GRAFT LESIONS
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1052
      Ahmed A. Almomani, et al.
    1. DIRECT ASSESSMENT OF MECHANICAL AORTIC AND MITRAL VALVE EFFECTIVE ORIFICE AREA WITH HIGH-FIDELITY PRESSURE WIRE FOR DECISION OF CONTROVERSIAL RE-VALVE REPLACEMENT
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 2183
      Shigetaka Kageyama
    1. SAFETY AND EFFICACY OF USING PRESSURE WIRE WITH DOBUTAMIN INFUSION IN THEMOYNAMIC ASSESSMENT OF LOW FLOW LOW GRADIENT AORTIC STENOSIS
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1037
      Zaher Fanari, et al.
    1. HEMODYNAMIC ASSESSMENT OF LOW FLOW, LOW GRADIENT SEVERE AORTIC STENOSIS WITH PRESERVED EF USING A PRESSURE WIRE
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1242
      Zaher Fanari, et al.
    1. IMPACT OF SALINE INDUCED PD/PA RATIO FOR PREDICTING FUNCTIONAL SIGNIFICANCE OF INTERMEDIATE CORONARY ARTERY STENOSIS ASSESED BY FRACTIONAL FLOW RESERVE
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1047
      Yoshiharu Fujimori, et al.
    1. IMPACT OF UTILIZING FRACTIONAL FLOW RESERVE WITH PERCUTANEOUS CORONARY INTERVENTION ON READMISSIONS: AN ANALYSIS OF THE 2013 NATIONAL READMISSIONS DATABASE
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1059
      Afnan R. Tariq, Aditya Mantha
    1. 2017, Page 1547
      David Barton, et al.
    1. SIGNIFICANCE OF MICROCIRCULATORY RESISTANCE IN VISUAL-FUNCTIONAL MISMATCH BETWEEN CORONARY ANGIOGRAPHY AND FRACTIONAL FLOW RESERVE IN NON-LEFT MAIN LESIONS
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1051
      Eisuke Usui, et al.
    1. INDEX OF MICROCIRCULATORY RESISTANCE FOR PREDICTING SEVERITY OF MYOCARDIAL INJURY AND CARDIAC FUNCTION AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: A CARDIAC MAGNETIC RESONANCE IMAGING STUDY
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 33
      Takayuki Onishi, et al.
    1. SEX DIFFERENCES IN THE RISK FACTORS FOR ENDOTHELIAL AND MICROVASCULAR DYSFUNCTION IN PATIENTS WITH ANGINA IN THE ABSENCE OF OBSTRUCTIVE CORONARY ARTERY DISEASE
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1749
      Vedant Pargaonkar, et al.
    1. THE PREDICTIVE VALUE OF MICROVASCULAR DEFECTS OBSERVED DURING DEMAND STRESS MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY AND QUANTITATIVE MEASUREMENTS OF STENOSIS AND MICROVASCULAR RESISTANCE OBTAINED DURING INVASIVE HEMODYNAMICS
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1547
      David Barton, et al
    1. UNRAVELLING THE MECHANISMS OF MENTAL STRESS INDUCED MYOCARDIAL ISCHAEMIA: NOVEL INSIGHTS FROM INTRACORONARY MEASUREMENTS DURING CARDIAC CATHETERISATION
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 13
      Satpal Arri, et al.
    1. FIVE YEAR OUTCOMES OF FRACTIONAL FLOW RESERVE GUIDED VERSUS INTRAVASCULAR ULTRASOUND GUIDED PERCUTANEOUS CORONARY INTERVENTION IN INTERMEDIATE CORONARY ARTERY DISEASE
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1170
      Yunkyeong Cho, et al.
    1. USEFULNESS OF OPTICAL COHERENCE TOMOGRAPHY-DERIVED MORPHOMETRIC ASSESSMENT TO PREDICT PHYSIOLOGICAL SIGNIFICANCE OF CORONARY ARTERY STENOSIS AND DETERMINANTS OF MISMATCH: HEAD-TO-HEAD COMPARISON WITH INTRAVASCULAR ULTRASOUND
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1077
      Eisuke Usui, et al.
    1. PREDICTORS OF FLOW-LIMITING FRACTIONAL FLOW RESERVE IN CORONARY LESIONS WITH INTERMEDIATE INSTANTANEOUS WAVE-FREE RATIO
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1060
      Yumiko Kanei, et al.
    1. COMPARISON OF ADENOSINE FRACTIONAL FLOW RESERVE AND POST-CONTRAST INSTANTANEOUS WAVE-FREE RATIO FOR HEMODYNAMIC ASSESSMENT OF MODERATE CORONARY STENOSES
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1058
      Samir B. Pancholy, et al.
    1. INSTANTANEOUS WAVE-FREE RATIO SCOUT PULLBACK (IFR SCOUT) PRE-ANGIOPLASTY PREDICTS HEMODYNAMIC OUTCOME IN HUMANS WITH CORONARY ARTERY DISEASE: PRIMARY RESULTS OF INTERNATIONAL MULTICENTRE IFR GRADIENT REGISTRY
      Journal of the American College of Cardiology, Volume 69, Issue 11, Supplement, 21 March 2017, Page 1050
      Christopher Cook, et al.

Link to case report