Deferral of left main coronary artery revascularization via IVUS or coronary physiology - Long-term outcomes from the SWEDEHEART registry

• Published in: International journal of cardiology 2025-01, Vol.419, p.132726, Article 132726
• Main Authors: Berntorp, Karolina, Mohammad, Moman A., Koul, Sasha, Yndigegn, Troels, Bergman, Sofia, Zwackman, Sammy, Linder, Rikard, Völz, Sebastian, Fröbert, Ole, Erlinge, David, Götberg, Matthias
• Format: Article
• Language: English
• Subjects: Aged; Cardiac and Cardiovascular Systems; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; Coronary Artery Disease - surgery; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Coronary Vessels - surgery; Deferral; Female; Follow-Up Studies; Fractional flow reserve; Fractional Flow Reserve, Myocardial - physiology; Humans; Instantaneous wave-free ratio; Intravascular imaging; Kardiologi; Left main coronary artery; Male; Middle Aged; Myocardial Revascularization - methods; Percutaneous Coronary Intervention - methods; Registries; Sweden - epidemiology; Time Factors; Treatment Outcome; Ultrasonography, Interventional - methods
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2024.132726

Intravascular ultrasound (IVUS) guides deferral decision-making regarding the left main coronary artery (LMCA) and improves outcomes. Further studies regarding coronary physiology to guide revascularization in the LMCA are needed. Our aim was to evaluate the outcome of LMCA deferral using IVUS or coronary physiology via instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR). Between January 2014 and February 2022, patients undergoing evaluation with either IVUS or coronary physiology in the LMCA were included from the SWEDEHEART registry. Exclusion criteria were a minimum luminal area