02799nam a2200289 4500 ESSALUD 20260804122304.0 ta t pe ||||| |||| 00| 0 spa d BMG eng Daemen, Joost Autor 53647 Angiography-based physiology to guide coronary revascularization páginas: 20-31 Background: Current society guidelines recommend physiological assessment of intermediate coronary lesions to guide revascularization. Data regarding revascularization guided by vessel fractional flow reserve (vFFR), derived from three-dimensional quantitative coronary angiography without the need for a pressure wire or hyperemic agent, as compared with pressure-wire–based fractional flow reserve (FFR), are lacking. Methods: We conducted an international, open-label, randomized, noninferiority trial at 37 sites in Europe. Patients with intermediate coronary-artery lesions (diameter stenosis of 30 to 80%) who presented with chronic or acute coronary syndromes were randomly assigned in a 1:1 ratio to undergo either vFFR-guided or FFR-guided revascularization of the intermediate coronary-artery lesions. The primary end point was a composite of death from any cause, any myocardial infarction, or any revascularization at 1 year. The noninferiority margin was 3.0 percentage points. Results: The primary end point was assessed in 1116 patients in the vFFR group and 1095 in the FFR group. The mean age of the patients was 67 years, 24.3% were women, 18.7% presented with an acute coronary syndrome, and 26.6% had diabetes mellitus. At 1 year, a primary end-point event had occurred in 80 patients (Kaplan–Meier estimate, 7.5%) in the vFFR group and in 79 patients (Kaplan–Meier estimate, 7.5%) in the FFR group (risk difference, −0.02 percentage points; 95% confidence interval, −2.25 to 2.21; P=0.004 for noninferiority). The incidence of serious adverse events appeared to be similar in the two groups. Conclusions: Among patients with intermediate coronary lesions, vFFR-guided revascularization was noninferior to FFR-guided revascularization with respect to a composite of death, myocardial infarction, or revascularization at 1 year. CARDIOLOGÍA GENERAL 53638 ENFERMEDAD CORONARIA 14895 INFARTO DE MIOCARDIO 13202 Van der Eijk, Jari A. 53648 Barbierato, Marco 53649 Byrne, Robert A. 38050 Canova, Paolo 53650 De Maria, Giovanni L. 53651 Van Belle, Eric 53652 22717 22634 Massachusetts NEJM Group NEJM001 The New England Journal of Medicine ESSALUD 0028-4793 ARTICULOS 2026-07-31 sqb 22722 22722