1. Continuous intracoronary versus standard intravenous infusion of adenosine for fractional flow reserve assessment: the HYPEREMIC trial
- Author
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Kim Cocks, Gregg W. Stone, Adam de Belder, Damien Collison, Ahmed Elghamaz, Keith G. Oldroyd, and Aung Myat
- Subjects
medicine.medical_specialty ,Adenosine ,Vasodilator Agents ,Hyperemia ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Coronary Angiography ,Washout period ,03 medical and health sciences ,Hyperaemia ,0302 clinical medicine ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,030212 general & internal medicine ,Infusions, Intravenous ,Cross-Over Studies ,Chest discomfort ,business.industry ,Coronary Stenosis ,Coronary Vessels ,Crossover study ,Confidence interval ,Fractional Flow Reserve, Myocardial ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
AIMS The aim of this study was to evaluate the accuracy of a continuous intracoronary (IC) adenosine infusion, administered through the novel HYPEREM™IC over-the-wire microcatheter, to measure fractional flow reserve (FFR). METHODS AND RESULTS The HYPEREMIC trial was a randomised, non-inferiority, crossover study in which patients with intermediate coronary lesions were enrolled for sequential pressure wire studies. FFR was measured using intravenous (IV) (140-180 mcg/kg/min) versus continuous non-weight-adjusted IC (360 mcg/min) adenosine. Patients were randomised and blinded to the order in which they received the adenosine, separated by a washout period. The primary endpoint was the mean hyperaemic FFR. Forty-one patients were enrolled at three UK sites between June and November 2016. The mean (standard deviation) FFR was 0.82 (±0.09) after IC versus 0.84 (±0.09) after IV adenosine. The difference of -0.02 (95% confidence interval [CI]: -0.03 to -0.01) confirmed the non-inferiority (margin
- Published
- 2020